14-04-30 陈松 尖峰眼科.docxVIP

Wills手册 第十一章 视网膜 第十二节 糖尿病性视网膜病变 郝晓军整理 打杂组出品 2014.10.19 11.12 Diabetic Retinopathy 第十二节? 糖尿病性视网膜病变 Diabetic Retinopathy Disease Severity Scale?? 【糖尿病性视网膜病变分级】 ???? No apparent retinopathy.?? 1、无显著的视网膜病变。 ???? Mild nonproliferative diabetic retinopathy (NPDR): Microaneurysms only.?? 2、轻度非增殖型糖尿病性视网膜病变(NPDR)??? 仅有微血管瘤。 ?? ???? Moderate NPDR: More than mild NPDR, but less than severe NPDR. See Figure 11.12.1.?? 3、中度非增殖型糖尿病视网膜病变(NPDR)??? 介于轻度和重度非增殖型糖尿病视网膜病变之间。见图11.12.1。 ? Severe NPDR: Any of the following in the absence of proliferative diabetic retinopathy: 20 intraretinal hemorrhages in each quadrant, two quadrants of venous beading, or one quadrant of prominent intraretinal microvasclar abnormalities (IRMA). See Figure 11.12.2.?? 4、重度非增殖型糖尿病视网膜病变(NPDR)?? 无增殖型糖尿病视网膜病变表现，出现以下体征之一:4个象限的视网膜内出血，每一个象限均超过20处，2个象限的静脉串珠样改变，或1个象限的显著的视网膜内微血管异常（IRMA）。见图11.12.2。 ???? ??? Proliferative diabetic retinopathy (PDR): One or more of: neovascularization (i.e., of the iris, angle, optic disc, or elsewhere), or vitreous/preretinal hemorrhage. See Figures 11.12.3 and 11.12.4. 5、增殖型糖尿病视网膜病变(PDR)?? 以下一项或多项：视盘上或距离1个视盘直径的范围内出现新生血管(NVD)，视网膜其他部位出现新生血管(NVE)，虹膜表面出现新生血管(NVI），前房角新生血管(NVA）；玻璃体积血或视网膜前出血。见图11. 12.3和图11 .12.4。?? ???? ??? Diabetic macular edema (DME): May be present in any of thestages listed above. Clinically significant macular edema (CSME) requires treatment and is defined as any one of the following (see Figures 11.12.5 and11.12.6): 6、糖尿病性黄斑水肿（DME）? 上述各期均可出现。有临床意义的黄斑水肿(CSME）需要治疗。出现以下情况之一，即可定义为有临床意义的黄斑水肿。见图11.12.5和图11.12.6。 1 Retinal thickening within 500 μm (one-third of disc diameter) of the foveal center. (1)黄斑中心凹视网膜增厚500um( 1/3视盘直径)。 2 Hard exudates within 500 μm of the foveal center, if associated with thickening of the adjacent retina. (2)硬性渗出位于距黄斑中心凹500um之内，合并周围视网膜增厚。 3??? Retinal thickening greater than one disc area in size, part of which is within one disc diameter of the center of the fovea. (3)视网膜增厚的范围1视盘直径(PD),且部分位于距黄斑中心凹1PD内。 Differential Diagnosis for Nonprolif