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光谱相干断层扫描青光眼:在结构诊断中的积极作用

Ko Eun Kim and Sohee Oh and Jin Wook Jeoung and Min Hee Suh and Je Hyun Seo and Martha Kim and Ki Ho Park and Dong Myung Kim and Seok Hwan Kim

期刊名称:American Journal of Ophthalmology

卷期:2016年第171卷

摘要

目的:旨在研究光谱域光学相干断层扫描(SDOCT)在青光眼结构性诊断中的积极作用。设计:可靠性和有效性分析。方法:选取109例健康个体的109只眼,151例不同严重程度青光眼患者的151只眼进行结构检查。使用立体视盘摄影(SDP),红色视网膜神经纤维层摄影(RNFLP)和SDOCT准备4种结构性诊断检查:(1SDPS),(2SDPSDOCTSO),(3SDPRNFLPSR),以及(4SDPRNFLPSDOCTSRO)。由五名青光眼专家按照SSOSRSRO,间隔一个月的顺序,使用4种诊断将每一个受试者分类为正常或青光眼。使用kappa(κ)统计来评估观察者间的一致性。使用广义估计方程评估SDOCT对专家诊断能力的累加效应。结果:在根据4种分类进行的诊断性评估上,5名青光眼专家显示出优异的一致性。在与专家的诊断能力比较中,将SDOCT添加到SDP中可将诊断准确度提高大约2倍。将SDOCT加入SDP可明显增强专家对中度青光眼的结构诊断能力,尽管不是轻度或晚期青光眼。结论:SDOCT显着提高了青光眼专科医生的诊断准确性,显示其在判断青光眼性结构损伤,特别是对中期青光眼的诊断价值。

Purpose To investigate the additive role of spectral-domain optical coherence tomography (SDOCT) in the structural diagnosis in glaucoma. Design Reliability and validity analysis. Methods Structural examinations from 109 eyes of 109 healthy individuals and 151 eyes of 151 glaucoma patients with different severities were included. Four structural-diagnostic examination sets were prepared using stereo-optic disc photography (SDP), red-free retinal nerve fiber layer photography (RNFLP), and SDOCT: (1) SDP (S), (2) SDP and SDOCT (SO), (3) SDP and RNFLP (SR), and (4) SDP, RNFLP, and SDOCT (SRO). Five glaucoma specialists were instructed to classify subjects as normal or glaucoma using each of the 4 diagnostic sets in the order S, SO, SR, and SRO, with a 1-month interval. The interobserver agreement was evaluated using kappa (κ) statistics. The additive effect of SDOCT on the diagnostic performance of the specialists was evaluated using the generalized estimating equation. Results Five glaucoma specialists showed an excellent level of interobserver agreement on the diagnostic assessments based on the 4 sets. In the comparison of the collective diagnostic performance of the specialists, addition of SDOCT to SDP showed an approximately 2-fold significant increase in the diagnostic accuracy. Adding SDOCT to SDP significantly enhanced the specialists' structural-diagnostic ability with respect to the moderate glaucoma, though not mild or advanced glaucoma. Conclusions SDOCT significantly enhanced the diagnostic accuracy of the glaucoma specialists' performance, showing its additive diagnostic value in judging glaucomatous structural damage, especially in the moderate stage of glaucoma. "


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