Wolfs R C, Ramrattan R S, Hofman A, de Jong P T
Department of Ophthalmology, Erasmus University, Rotterdam, The Netherlands.
Ophthalmology. 1999 Aug;106(8):1597-601. doi: 10.1016/S0161-6420(99)90458-X.
To determine the correlations between ophthalmoscopic estimations and the measurements with a semiautomated image-analysis device of the vertical cup-to-disc ratio (VCDR) in the human optic disc.
Population-based, cross-sectional study.
All subjects 55 years of age and older from the population-based sample of 6777 ophthalmologically examined subjects from The Rotterdam Study of whom gradable optic disc transparencies of at least 1 eye and ophthalmoscopic data of the same eye were available.
Ophthalmoscopic assessment of the VCDR and semiautomated measurement of the VCDR.
Indirect and direct ophthalmoscopy were performed in mydriasis to assess the VCDR. Optic disc transparencies made with a simultaneous stereoscopic telecentric fundus camera were analyzed with a semiautomated measurement system (Topcon Imagenet).
In 5143 subjects, the mean ophthalmoscopic VCDR was 0.30 (standard error [SE], 0.0021; range, 0.00, 1.00) compared with a semiautomatically measured VCDR of 0.49 (SE, 0.0019; range, 0.04, 0.86; difference, 0.19; P < 0.0001). The overall correlation between both methods was moderate (correlation coefficient, 0.61; SE, 0.11) and lower in small optic discs. Semiautomated optic disc measurements correctly identified 76% of the glaucoma cases (as defined using visual field data and ophthalmoscopic data about the optic disc).
Semiautomated measurements of the VCDR are larger than the ophthalmoscopic VCDR estimate with a moderate correlation. The interobserver variability using Imagenet was smaller compared with the ophthalmoscopic assessments, and Imagenet was better standardized, which is important for epidemiologic surveys and follow-up studies.
确定检眼镜评估与使用半自动图像分析设备测量人视盘垂直杯盘比（VCDR）之间的相关性。
基于人群的横断面研究。
来自鹿特丹研究中6777名接受眼科检查的基于人群样本中的所有55岁及以上受试者，其中至少有一只眼睛的可分级视盘透明度数据以及同一只眼睛的检眼镜数据可用。
VCDR的检眼镜评估和VCDR的半自动测量。
在散瞳状态下进行间接和直接检眼镜检查以评估VCDR。使用同步立体远心眼底相机拍摄的视盘透明度图像通过半自动测量系统（Topcon Imagenet）进行分析。
在5143名受试者中，检眼镜测量的平均VCDR为0.30（标准误差[SE]，0.0021；范围，0.00至1.00），而半自动测量的VCDR为0.49（SE，0.0019；范围，0.04至0.86；差值，0.19；P < 0.0001）。两种方法之间的总体相关性为中等（相关系数，0.61；SE，0.11），在小视盘中相关性较低。半自动视盘测量正确识别了76%的青光眼病例（根据视野数据和视盘的检眼镜数据定义）。
VCDR的半自动测量值大于检眼镜VCDR估计值，两者相关性中等。与检眼镜评估相比，使用Imagenet的观察者间变异性较小，且Imagenet标准化程度更高，这对流行病学调查和随访研究很重要。
