立体数字成像与幻灯片胶片摄影在黄斑变性识别中的比较。

Comparison of stereoscopic digital imaging and slide film photography in the identification of macular degeneration.

作者信息

Somani Riz, Tennant Matt, Rudnisky Chris, Weis Ezekiel, Ting Andrew, Eppler Jayson, Greve Mark, Hinz Brad, de Leon Alex

机构信息

Department of Ophthalmology, Royal Alexandra Hospital, University of Alberta, Edmonton, Canada.

出版信息

Can J Ophthalmol. 2005 Jun;40(3):293-302. doi: 10.1016/S0008-4182(05)80072-9.

DOI:10.1016/S0008-4182(05)80072-9

PMID:15947799

Abstract

BACKGROUND

This study compared the sensitivity and specificity of stereoscopic digital photography of the retina through a dilated pupil with a 45 degrees nonmydriatic camera and Joint Photographic Experts Group (JPEG) compression of the images with the sensitivity and specificity of 35-mm slide film photography in the identification of age-related macular degeneration (AMD).

METHODS

Consecutive patients with a diagnosis of AMD were enrolled. Stereoscopic retinal images of the disc, macula and temporal macula were captured with a digital 45 degrees nonmydriatic camera (then compressed into JPEG format) and with a standard fundus camera and slide film. A single retinal specialist graded both image formats in masked fashion, at least 1 month apart, using a modified Age-Related Eye Disease Study (AREDS) severity scale. The digital images were displayed on a monitor and viewed with the use of liquid crystal display shutter glasses and stereo imaging software. The film images were mounted on a light box and graded with the use of a stereoviewer. Primary outcome measures included the presence or absence of AMD pathological features. Positive and negative predictive values (PPVs and NPVs), sensitivity, specificity and weighted kappaw statistics were calculated.

RESULTS

We photographed 203 eyes (of 103 patients) with both digital and slide film cameras. Correlation of the 2 image formats was substantial in identifying AREDS level 3a or greater (kappaw=0.64, standard error=0.08, PPV=0.95, NPV=0.66, sensitivity=0.93, specificity=0.74) and excellent in identifying level 4b or greater (kappaw=0.83, standard error=0.05, PPV=0.81, NPV=0.98, sensitivity=0.94, specificity=0.94).

INTERPRETATION

High-resolution stereoscopic, mydriatic, 45 degrees digital images captured with a nonmydriatic camera and JPEG compressed correlate well with stereoscopic slide film photographs in the identification of moderate to advanced AMD (AREDS level 3a or greater).

摘要

背景

本研究比较了使用45度非散瞳相机通过散瞳拍摄视网膜的立体数码摄影及图像的联合图像专家组（JPEG）压缩，与35毫米幻灯片摄影在识别年龄相关性黄斑变性（AMD）方面的敏感性和特异性。

方法

纳入连续诊断为AMD的患者。使用数码45度非散瞳相机（然后压缩为JPEG格式）以及标准眼底相机和幻灯片胶片，拍摄视盘、黄斑和颞侧黄斑的立体视网膜图像。由一名视网膜专科医生以盲法对两种图像格式进行分级，间隔至少1个月，采用改良的年龄相关性眼病研究（AREDS）严重程度量表。数码图像在显示器上显示，并使用液晶显示快门眼镜和立体成像软件进行查看。胶片图像安装在灯箱上，并使用立体观察器进行分级。主要结局指标包括是否存在AMD病理特征。计算阳性和阴性预测值（PPV和NPV）、敏感性、特异性和加权卡帕统计量。

结果

我们使用数码和幻灯片胶片相机拍摄了103例患者的203只眼。两种图像格式在识别AREDS 3a级或更高级别方面具有高度相关性（卡帕=0.64，标准误=0.08，PPV=0.95，NPV=0.66，敏感性=0.93，特异性=0.74），在识别4b级或更高级别方面具有极好的相关性（卡帕=0.83，标准误=0.05，PPV=0.81，NPV=0.98，敏感性=0.94，特异性=0.94）。