Trible J R, Schultz R O, Robinson J C, Rothe T L
Eye Institute, Medical College of Wisconsin, Milwaukee, USA.
Arch Ophthalmol. 1999 Oct;117(10):1298-304. doi: 10.1001/archopht.117.10.1298.
To determine the diagnostic accuracy of scanning laser polarimetry.
A total of 95 healthy subjects and 102 patients with glaucoma met all inclusion criteria. Data collected on each participant included an automated visual field examination, stereoview optic nerve head photographs, intraocular pressure measurement, and a screening and full scanning laser polarimetry study. Each participant was classified as "normal," "glaucoma," or "uncertain" by each of 3 ophthalmologists based on all available clinical information, with the exception of the scanning laser polarimetry results. Before data analysis, 4 diagnostic algorithms for the full-test mode and 2 for the screening mode were chosen to be evaluated for their sensitivity and specificity in detecting glaucoma.
Of the 4 algorithms tested for the full-test mode, "the number" (abnormal test score, >35) had sensitivities of 57%, 71%, and 81% for early, moderate, and severe glaucoma, respectively. Specificity was 89%. For the screening test, sensitivities were much lower, particularly for those with severe glaucoma damage.
Scanning laser polarimetry can help to differentiate subjects with normal findings from patients with glaucomatous damage. Even the best algorithm tested, however, failed to detect a substantial number of subjects with severe damage. Further study is needed before scanning laser polarimetry can be recommended as a screening method for glaucoma.
确定扫描激光偏振仪的诊断准确性。
共有95名健康受试者和102例青光眼患者符合所有纳入标准。收集的每位参与者的数据包括自动视野检查、立体视盘视神经乳头照片、眼压测量以及筛查和全视野扫描激光偏振仪研究。除扫描激光偏振仪结果外，3名眼科医生根据所有可用临床信息将每位参与者分类为“正常”、“青光眼”或“不确定”。在数据分析之前，选择了4种全视野测试模式的诊断算法和2种筛查模式的算法，评估它们在检测青光眼方面的敏感性和特异性。
在全视野测试模式下测试的4种算法中，“数值”（异常测试分数，>35）对早期、中度和重度青光眼的敏感性分别为57%、71%和81%。特异性为89%。对于筛查测试，敏感性要低得多，尤其是对于那些有严重青光眼损害的患者。
扫描激光偏振仪有助于区分检查结果正常的受试者和患有青光眼损害的患者。然而，即使是测试的最佳算法也未能检测出大量有严重损害的受试者。在推荐扫描激光偏振仪作为青光眼筛查方法之前，还需要进一步研究。
