Characteristics Of OCT And OCTA In Patients With Non-Proliferative Diabetic Retinopathy Of Different Traditional Chinese Medicine Syndromes

Objective:In this study the proliferation period in patients with diabetic retinopathy(NPDR)as the main research object,research based on optical coherence tomography(OCT),optical coherence tomography imaging(OCTA)check blood flow,discusses two deficiency qi and Yin,collaterals syndrome and liver and kidney deficiency and blood stasis resistance,mesh winding alongwith the related to check the different characteristics of performance,In order to provide a new idea for the diagnosis,classification and treatment of NPDR patients through the combination of TCM syndrome differentiation and modern imaging examination.Methods:In this study,a cross-sectional study was adopted,and a total of 30 NPDR patients who met the inclusion and exclusion criteria and 30 normal control subjects were collected from the Affiliated Eye Hospital of Chengdu University of Traditional Chinese Medicine from April 2020 to December 2020.DR group was divided into mild NPDR group(L group),moderate NPDR group(M group)and severe NPDR group(H group).According to the dialectical theory of traditional Chinese medicine,they were divided into two groups: deficiency of Qi and Yin,collaterals stasis group(QY group),deficiency of liver and kidney,and deficiency of eye collaterals group(GS group).Thirty patients with diabetic retinopathy(DR)were staged.All enrolled patients underwent OCT,OCTA,blood biochemical and Hb A1 c examinations,and the analysis software of the equipment was used to calculate the mean macular thickness(CAT),central sub-macular thickness(CST)and macular volume(CV).Then switch to Angio Retina mode,collect images with a range of 3mm*3mm and 6mm*6mm respectively,and calculate the blood perfusion density Pd,the area,circumference,morphological index and vascular linear density Vd of the fovea macular avascular area(FAZ)through the analysis software of the device.Biochemistry and Hb A1 c tests are obtained after blood sampling and the patient’s data are entered in the Case Report Form(CRF).Results:1.A total of 30 patients with NPDR were recruited in this study,including 9,11 and10 patients with mild,moderate and severe NPDR,including 16 males and 14 females.At the same time,30 normal subjects were recruited,including 14 men and16 women.The general data of normal control group,L,M and H groups were compared,and there was statistical significance in the course of disease between patients with different degrees of NPDR and the normal healthy group(P < 0.05),and the H group was significantly higher than the L group,M group and the normal group.There was no significant difference in other general conditions among the four groups(P > 0.05).3.Comparison of laboratory indicators among the four groups showed statistically significant differences(P<0.05).Four group of random two group of contrast results demonstrated,vision for control group remarkable good in other each group.Fasting blood glucose(FPG)and Hb A1 c are H group obviously are higher than other each group.4.The differences of OCT indexes among the four groups were statistically significant(P<0.05),and the results of comparison between any two groups showed that CST,CAT and CV in group H were significantly higher than those in group L,group M and control group.5.Among the NPDR subjects recruited this time,there were 20 people in QY group and 10 people in GS group.After comparing the general data between the two groups of patients with different dialectical types of TCM,it was found that the difference in the course of disease was statistically significant(P<0.05),and the GS group was significantly higher than the QY group.In comparison between the two groups,the differences in other general information were not statistically significant(P>0.05).Comparing the indexes of OCTA 3mm*3mm and 6mm*6mm scanning between different syndrome types of the two groups,it was found that the QY group was significantly higher than the GS group in scanning VD with OCTA3mm*3mm,scanning VD with OCTA 6mm*6mm and scanning PD with OCTA6mm*6mm;The FAZ area of 3mm*3mm,the FAZ perimeter of 3mm*3mm,6mm*6mm and the FAZ perimeter of 6mm*6mm were significantly higher in GS group than in QY group.6.The results of the comparison of laboratory indicators between the two groups of different TCM syndromes showed that the differences were statistically significant(P<0.05),and the visual acuity was low in the GS group,and the FPG and Hb A1 c levels were both high in the GS group.Comparing the OCT indicators between the two groups,the difference was statistically significant(P <0.05),and the GS group was significantly higher than the QY group.Conclusion:1.The results of OCT showed that the indexes of patients in the severe NPDR group were higher than those in the moderate and mild groups,indicating that with the progress of NPDR,the retina gradually thickened;OCTA results showed that,with the exacerbation of the disease,it suggested the exacerbation of macular ischemia,and these indicators could be used as the specific indicators of the disease changes in NPDR patients.2.The results of OCT showed that the retinal thickness of the patients with deficiency of liver and kidney was higher in the group with deficiency of Qi and Yin than in the group with deficiency of Qi and Yin,and that of the group with collaterals stasis.The results of OCTA showed that liver and kidney deficiency,macular ischemia was more serious in the group of eye collaterals deficiency than that of Qi and Yin deficiency,and collaterals stasis group.According to patients’ TCM symptoms,combined with quantitative indicators such as OCT and OCTA,guide TCM syndrome differentiation treatment;3.With the development of NPDR,the TCM syndrome types of patients changed from deficiency of Qi and Yin,collaterals stasis to deficiency of liver and kidney,and deficiency of eyes and collaterals.The classification of DR in Western medicine also changed from mild NPDR,moderate NPDR to severe NPDR.4.The levels of FPG and Hb A1 c in patients with different degrees of NPDR increased gradually,which could be used to evaluate the influence of patients’ blood glucose control on the changes of DR disease.