论文部分内容阅读
目的通过免散瞳眼底数码照相方法诊断白内障并筛出白内障需手术者,探讨用该方法筛查白内障的可行性。设计前瞻性病例系列。研究对象2009年2月至8月同仁医院白内障中心就诊的白内障患者92例165眼。方法所有病例均检查裸眼视力及矫正视力,经裂隙灯显微镜检查并进行白内障分类分级。使用免散瞳眼底数码照相机进行小瞳孔眼底数码照相检查,根据眼底照片的模糊程度作出分级诊断。比较免散瞳眼底照相的诊断结果与裂隙灯检查结果的一致性,两种手术诊断标准所得筛查结果进行Kappa检验。主要指标灵敏度、特异度、约登(Youden)指数、阳性预测值、阴性预测值。结果免散瞳眼底照相与裂隙灯检查结果呈高度一致性。以裂隙灯显微镜检查为金标准,各级白内障中2级以上者免散瞳眼底照相诊断的灵敏度均在89%以上。免散瞳眼底照相筛查白内障需手术者的Kappa值均达0.70以上。皮质性、核性和囊下性的阳性预测值分别为100%、84.2%和76.2%,阴性预测值分别为82.4%、93.3%和91.9%。结论用免散瞳眼底照相方法筛查明显影响视力的中、重度白内障是可行的。可以用免散瞳眼底照相方法替代裂隙灯显微镜检查法筛查白内障需手术者。
Objective To investigate the feasibility of using this method to screen cataracts by diagnosing cataracts and screening out cataracts by using the method of digital unmanned digital fundus photography. Design prospective case series. Participants 92 patients (165 eyes) with cataract treated in the Tongren Hospital Cataract Center from February to August 2009. Methods All cases were examined uncorrected visual acuity and corrected visual acuity, slit lamp microscopy and cataract classification. Use mydriasis fundus digital camera for small pupil fundus digital camera examination, according to the degree of blurring fundus photographs to make a grade diagnosis. Comparing the diagnostic results of unmotile-mydriatic fundus photography with the slit-lamp examination results, Kappa test was used for the screening results of the two surgical diagnostic criteria. The main indicators of sensitivity, specificity, Youden index, positive predictive value, negative predictive value. Results No mydriasis fundus photography and slit lamp examination showed a high degree of consistency. Slit lamp microscopy as the gold standard, at all levels of cataract more than two were without mydriasis fundus photography sensitivity of more than 89%. Non-mydriatic fundus photography for cataract surgery required Kappa value of more than 0.70. The positive predictive values for cortical, cystic and subaccular sex were 100%, 84.2% and 76.2%, respectively, with negative predictive values of 82.4%, 93.3% and 91.9%, respectively. Conclusion It is feasible to use the mydriatic fundus photography in the screening of moderate and severe cataract obviously affecting visual acuity. You can use non-mydriatic fundus photography instead of slit lamp microscopy screening for cataract surgery.