国际眼科纵览 ›› 2021, Vol. 45 ›› Issue (3): 204-210.doi: 10.3760/cma.j.issn.1673-5803.2021.03.006

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糖尿病视网膜病变微动脉瘤的影像学表现

张璟,丁琳   

  1. 新疆医科大学,乌鲁木齐 830054
  • 收稿日期:2020-10-09 出版日期:2021-06-22 发布日期:2021-06-22
  • 通讯作者: 丁琳,Email:dinglin85600@163.com

Imaging of microaneurysms in diabetic retinopathy

Zhang Jing, Ding Lin    

  1. Xinjiang Medical University, Urumqi 830054, China 
  • Received:2020-10-09 Online:2021-06-22 Published:2021-06-22
  • Contact: Ding Lin, Email:dinglin85600@163.com

摘要: 微动脉瘤(microaneurysms,MA)超微结构分四种:I型血管内皮完整,但缺少周细胞;II型血管管腔内有红细胞,内皮细胞和周细胞缺如;III型管腔内为不规则形状的红细胞轮廓,部分管腔闭塞;IV型血管完全硬化。彩色眼底照相MA表现为红色小圆点,直径15~60 μm。荧光素眼底血管造影被认为是诊断MA的金标准,表现为动脉期出现的边界清晰的圆形、大小不等的强荧光点,部分可见晚期荧光素渗漏。相干光断层扫描上 MA呈高反射性环形囊腔结构,分为三型:完整的环形结构型、不完整型、无环形结构型。相干光断层扫描血管造影对MA的分型包括局灶突起型、球囊状型、梭状型、混合型、带蒂型、不规则型。多光谱眼底分层成像系统550 nm、580 nm、590 nm均显示为黑色小圆点,在伪彩图中则表现为红色圆点。眼底炫彩激光扫描成像较眼底照相可更清晰显示MA为黑色小点(低反射信号),检出率高于眼底照相。(国际眼科纵览,2021, 45:204-210)


关键词: 糖尿病视网膜病变, 微动脉瘤

Abstract: Microaneurysm (MA) has four types of ultrastructures: Type I vascular endothelium is intact but lacks pericytes; Type II blood vessels have red blood cells in the lumen, but endothelial cells and pericytes are absent; Type III irregularly shaped red blood cell contour in the lumen, part of the lumen is occluded; and Type IV blood vessels are completely hardened. Color fundus photography MA showed small red dots with a diameter of 15-60 μm. Fundus fluorescein angiography is considered to be the gold standard for diagnosis of MA. It is manifested by the arterial phase with sharply defined circles and strong fluorescent spots of varying sizes, and some late fluorescein leakage can be seen. On OCT, MA is a highly reflective ring-shaped cyst structure, which is divided into three types: complete ring-shaped structure type, incomplete type, and non-ring-shaped structure type. The classification of MA by OCTA includes focal bulging, saccular, fusiform, mixed, pedunculated, and irregular. The multispectral ocular fundus imaging 550 nm, 580 nm, and 590 nm are all displayed as small black dots, and in the pseudo-color image, they are displayed as red dots. The multicolor scanning laser imaging can show the MA as small black dots (low reflection signal) more clearly than fundus photography, and the detection rate is higher than fundus photography. (Int Rev Ophthalmol, 2021, 45: 204-210)

Key words: diabetic retinopathy, microaneurysm