Newsom R, Moate B, Casswell T
Sussex Eye Hospital, Brighton, UK.
Eye (Lond). 2000 Aug;14 ( Pt 4):579-82. doi: 10.1038/eye.2000.146.
To evaluate digital colour photography and oral fluorescein angiography (OFA) for diabetic retinopathy screening.
Thirty-seven patients were selected from either a diabetic retinopathy screening or a medical retina clinic. Three 45 degrees colour digital images and a single macula 45 degrees OFA image were taken from each eye. Standard seven-field stereo photography with ETDRS grading was used as a gold standard for data comparison. The images were assessed by two graders and the results of each method compared using the McNemar test.
Five eyes had no diabetic retinopathy, 50 had background diabetic retinopathy, 3 had pre-proliferative diabetic retinopathy, 11 had proliferative disease and 3 had quiescent posttreatment disease. Clinically significant macular oedema was present in 25 eyes and absent in 48. For grading diabetic retinopathy digital colour photography produced a sensitivity of 0.87 (specificity 0.83); OFA produced a sensitivity of 0.87 (specificity 0.80) (p = 0.1). For the detection of diabetic maculopathy, the sensitivity of digital colour photography was 0.48 (specificity of 0.95) and for OFA was 0.87 (specificity 0.87) (p < 0.01).
This pilot study has shown that both digital colour photography and OFA compare well with conventional methods for diabetic retinopathy screening. The results encourage the further evaluation of OFA in the screening for diabetic maculopathy.
评估数字彩色摄影和口服荧光素血管造影术（OFA）用于糖尿病视网膜病变筛查的效果。
从糖尿病视网膜病变筛查或医学视网膜诊所选取37例患者。每只眼睛拍摄三张45度彩色数字图像和一张黄斑区45度OFA图像。采用标准七视野立体摄影及ETDRS分级作为数据比较的金标准。图像由两名分级者评估，各方法的结果采用McNemar检验进行比较。
5只眼无糖尿病视网膜病变，50只眼有背景性糖尿病视网膜病变，3只眼有增殖前期糖尿病视网膜病变，11只眼有增殖性病变，3只眼有静止期治疗后病变。25只眼存在临床上显著的黄斑水肿，48只眼不存在。对于糖尿病视网膜病变分级，数字彩色摄影的敏感度为0.87（特异度0.83）；OFA的敏感度为0.87（特异度0.80）（p = 0.1）。对于糖尿病黄斑病变的检测，数字彩色摄影的敏感度为0.48（特异度0.95），OFA的敏感度为0.87（特异度0.87）（p < 0.01）。
这项初步研究表明，数字彩色摄影和OFA在糖尿病视网膜病变筛查方面与传统方法相比效果良好。研究结果鼓励进一步评估OFA在糖尿病黄斑病变筛查中的应用。
