Exploring The Correlation Between AMD Fundus Features And TCM Syndrome Types Based On Fundus Image Analysis Technolog

Objective:1.Linking TCM syndrome types and objective indicators,analyzing their internal relationship,and providing objective theoretical basis for measuring macular choroidal thickness,macular retinal thickness,and CNV type as objective indicators for ARMD disease assessment,prognosis and treatment effect;2.Design an OCT choroid calibration algorithm,similar to the detection of retinal nerve fiber layer thickness,and incorporate choroidal thickness data into the clinical detection of OCT;3.To provide theoretical support for the establishment of a digital TCM eye diagnosis system,and to provide new ideas for the development of TCM eye diagnosis instruments.Methods:Selected from the First Affiliated Hospital of Hunan University of Traditional Chinese Medicine,200 AMD patients who met the inclusion criteria were objectively divided into spleen deficiency and dampness sleep syndrome,yin deficiency and fire hyperactivity syndrome,and phlegm and blood stasis syndrome according to the syndrome scale.There were 50 patients in each of 4syndrome types: syndrome and liver-kidney deficiency syndrome.At the same time,50 healthy subjects from the physical examination center of our hospital were selected as the control group,with a total of 5 groups.General information and syndrome information were recorded,and OCT was used to measure the thickness of choroid and retina in the macular region.FFA and IGGA were used to detect the types of CNV in patients with exudative AMD in different syndromes.Statistical analysis was performed using statistical software.Results:1.There were 200 AMD patients(200 affected eyes),including96 males and 104 females,with an average age of 61.34 ±15.25 years(52-79 years).There were 50 normal controls(50 eyes),including 22 males and 28 females,with an average age of 60.34 ±9.61 years(50-79years).After statistical analysis,the groups were balanced.2.Fundus changes occurred in 200 of 200 AMD patients,accounting for 100%.The highest frequency of macular changes in AMD patients was unclear bright spots(85.50%)> rigid exudation(69.00%)> hemorrhage(60.00%)> pigment disorder(59.50%)> soft Exudation(41.00%)> drusen(36.00%)>cystoid edema(34.00%)> bright spot(14.50%)> fissure(1.50%).3.The distribution of TCM syndrome types of macular changes was as follows: rigid exudation(74.00 %)accounted for the highest proportion in spleen deficiency and dampness trapped;bright spots were unclear(98.00%),and pigment disorder(98.00%)accounted for phlegm and blood stasis.The proportion was the highest;rigid exudation(80.00%)and bright spots were unclear(100%)accounted for the highest proportion in yin deficiency and fire exuberance;drusen(92.00%)accounted for the highest proportion in liver and kidney deficiency.4.The average subfoveal choroid and retin al thicknesses of different syndrome types are correlated,the yin deficiency and phlegm and blood stasis type are thicker than the spleen deficiency dampness type and liver and kidney deficiency type(P<0.05),the phlegm and blood stasis type is thicker than yin deficiency type and phlegm and blood stasis type.There was no significant difference between the types of deficiency and fire(P> 0.05),and there was no significant difference between the type of spleen deficiency and dampness and deficiency of liver and kidney(P> 0.05).5.Among different syndrome types,the percentages of typical CNV diagnosed in the spleen-deficiency dampness-stagnation group and the liver-kidney-deficiency group were relatively low,while the typical CNV diagnoses in the yin-deficiency fire-prosperity group and the phlegm-stasis interlocking group accounted for 77.14% and68.09%,respectively,compared with A.,D group was higher,and the difference was statistically significant(P<0.05).Conclusion: The common manifestations of macular changes in AMD patients are unclear bright spots,hemorrhage,hard exudation,pigment disorder,etc.According to the classification and comparison,it is inferred that there is a correlation between AMD fundus characteristics and TCM syndrome types.The retinal thickness and choroidal thickness of AMD patients with yin deficiency and fire and phlegm and blood stasis were higher than those of spleen deficiency and dampness and liver and kidney insufficiency.When obvious hard exudation is found by fundus photography,OCT,FFA,ICGA etc.,it may be considered as spleen deficiency and dampness sleep syndrome;when obvious bleeding or edema is found,it may be considered as yin deficiency and fire hyperactivity syndrome;When it is found that the clear bright spots and hard exudation have no other special changes,it may be a syndrome of liver and kidney deficiency.