免散瞳超广角视网膜成像与散瞳前置镜眼底检查在老年眼病评估中的对比研究

A contrast Study of Non-mydriatic ultra-wide-field retinal imaging and Mydriatic Preplaced-mirrow Ophthalmoscopy in Evaluation of the Senile Eye Diseases

中文关键词: 老年  视网膜成像  广角  散瞳

英文关键词: elderly  retinal imaging  ultra-wide-field  pupil dilation

中文摘要:

      目的 应用免散瞳超广角视网膜成像系统(ultra-wide-field retinal imaging system,UWRIS)进行眼底检查,并与传统散瞳前置镜眼底检查进行对比,评估两者检查结果的一致性并分析其特点.方法 选择105例老年受试者(共210眼),应用UWRIS进行免散瞳眼底图像采集,而后由眼科医师进行散瞳后裂隙灯下前置镜眼底检查,记录2种检查方法的检查时间.按照“存在”或“不存在”的标准分别记录每只眼可能的病变类型及位置.2种方法检查结果不一致时由眼底病专家重新评判.结果 受试者双眼接受UWRIS检查的平均时间[(6.3±2.6)min]明显少于散瞳前置镜眼底检查的时间[(26.5±5.2)min] (P＜0.01).2种检查方法在视盘和后极部黄斑区域中视网膜出血和脉络膜萎缩的检出结果一致性较好(Kappa值＞0 7),对于玻璃膜疣的检出结果一致性属中等水平(Kappa值=0.44/0.48),在中周部视网膜区域中脉络膜萎缩和动脉硬化的检出一致性较好(Kappa值＞0.7),在玻璃膜疣、视网膜出血、周边视网膜变性和玻璃体视网膜交界性异常的检出结果一致性属中等水平或以下(Kappa值＜0.5).在2种检查方法结果不一致的情况下,经专家对2种检查方法结果进行判定,UWRIS成像系统对于视网膜特定部位的病变筛查结果更具准确性.结论 与传统散瞳前置镜眼底检查相比,免散瞳UWRIS检查快速无创,对于老年受试者视网膜不同部位的特定疾病有较高的病变检出率.

英文摘要:

      Objective To compare the application of non-mydriatic ultra-wide-field retinal imaging with that of traditional mydriatic preplaced-mirrow ophthalmoscopy in senile fundus examination,to evaluate the consistency of the 2 and to analyze their characteristics.Methods 105 senile volunteers were selected,in total 210 eyes;UWRIS was performed on all the volunteers and the images were collected,then fundus examinations were made by professional technicians,using noncontact indirect ophthalmoscope after diluting the pupils;the time of the 2 examinations was recorded respectively;the possible lesion type and location of each eye was recorded as "present" or "absent";experts of fundus diseases evaluated the discordant results.Results The mean time of UWRIS examination was (6.3±2.6) minutes,much shorter than that of indirect ophthalmoscopy examination (26.5 ± 5.2) minutes (P ＜ 0.01);in posterior pole/macula zone,the 2 examination methods were of high consistency in the detection of retinal hemorrhage and choroidalatrophy (Kappavalue＞0.7) and of medium consistency in the detection of drusen (Kappa value=0.44/0.48);in middle to peripheral retina zone,the 2 examination methods were of high consistency in the detection of choroidalatrophy and retinal atherosclerosis (Kappa value ＞ 0.7) and of medium consistency in the detection of drusen,retina hemorrhage,peripheral retina degeneration and vitreoretinal interface abnormality (Kappa value ＜0.5);The evaluation of discordant results made by the experts indicated that screening results of UWRIS were more accurate than those of the conventional method.Conclusions Compared with conventional non-contact indirect ophthalmoscopy,UWRIS is a more rapid,non-invasive and non-mydriatic examination for senile specific fundus diseases and it can improve the detection rate.