Study On The Correlation Between Diabetic Choroidal Disease And Retinopathy

Objective: To observe the changes of choroidal microcirculation and thickness in diabetic patients by indocyanine green angiography(ICGA)combined with optical coherence tomography(OCT).Analyze the correlation between the changes of choroidal microcirculation and thickness with the duration of diabetes and the severity of diabetic retinopathy in diabetic patients.Methods: Research objects: Select 65 patients(130 eyes)who attended the ophthalmology department of the First Affiliated Hospital of Jiamusi University from January2019 to June 2020,who were diagnosed with type 2 diabetes in a tertiary hospital or above,and then included them in diabetes group,and 15 cases(30 eyes)of healthy peers were selected as the control group.All study subjects underwent detailed eye examinations and were accurately grouped according to the examination results,among them,the diabetes component is divided into 3 groups:1)56 eyes in NDR group;2)44 eyes in NPDR group;3)30 eyes in PDR group;The NDR group is divided into 3 groups: 1)NDR course ≤ 5 years,12 eyes;2)NDR course 5-10 years,28 eyes;3)NDR course ≥ 10 years,16 eyes.ICGA was performed on all study subjects to observe the proportion and characteristics of abnormal fluorescence during the angiography process and record the arm-choroidal artery filling time.At the same time,OCT was performed on all subjects and the subfoveal thoroidal thickness(SFCT)was measured.By comparing the abnormal fluorescence ratio and SFCT of NDR diabetic patients with different courses,explore the changes of choroid in diabetic patients without fundus retinopathy;Through the study of the choroid of patients with NDR,NPDR and PDR,we explored the changing trend of arm-choroidal artery filling time and SFCT with the progress of DR severity.Results:(1)With the extension of the course of diabetes,the proportion of patients with abnormal fluorescence in NDR patients gradually increased,and the difference was statistically significant(P〈0.05).(2)SFCT of NDR patients was negatively correlated with the course of diabetes(r=-0.477,P〈0.05).The difference of SFCT among the 4groups was statistically significant(P〈0.05).Comparison of SFCT between each two groups: NDR course 5-10 years group,NDR course ≥10 years group compared with control group,NDR course ≥10 years group and NDR course ≤5 years group,the difference was statistically significant(P 〈0.05);There was no statistical significance among other groups compared with each other(P〉0.05).(3)The arm-choroidal artery filling time of DR patients was positively correlated with the severity of DR(r=0.655,P〈0.05).Comparison of arm-choroidal artery filling time between the 4 groups was statistically significant(P〈0.05).Comparison of arm-choroidal artery filling time between each two groups: comparison between NDR group,NPDR group,PDR group and control group,and comparison between PDR group and NDR group,the difference was statistically significant(P〈0.05);There was no statistical significance among other groups compared with each other(P〉0.05).(4)SFCT of DR patients was negatively correlated with the severity of DR(r=-0.548,P〈0.05).The SFCT comparison between the 4 groups was statistically significant(P〈0.05);The SFCT comparison between each two groups: NDR group,NPDR group,PDR group and control group,PDR group and NDR group,the difference was statistically significant Academic significance(P〈0.05);There was no statistical significance among other groups compared with each other(P〉0.05).Conclusions:(1)The changes of choroidal microcirculation in diabetic patients are earlier than retinopathy.After 10 years of diabetes,most patients will experience changes in choroidal morphology with function that are not easily detectable.(2)The changes of choroidal microcirculation and thickness in patients with diabetic retinopathy are highly correlated with diabetic retinopathy.The more severe the DR,the longer the choroidal artery filling time and the thinner the choroidal thickness under the fovea.