Jelinek Herbert J, Cree Michael J, Worsley David, Luckie Alan, Nixon Peter
School of Community Health, Charles Sturt University, Albury, Australia.
Clin Exp Optom. 2006 Sep;89(5):299-305. doi: 10.1111/j.1444-0938.2006.00071.x.
With the increase in the prevalence of diabetes, rural optometric clinics stand to increase their patient load and assessment of diabetic eye disease. This study aimed to assess whether automated identification of diabetic retinopathy based on the presence of microaneurysms is an effective tool in clinical practice.
We analysed 758 fundal images of 385 patients with diabetes attending the clinic obtained using a Canon CR5 with an EOS10 digital camera through a dilated pupil. Five optometrists employed in the clinic assessed the diabetic retinopathy using binocular indirect ophthalmoscopy. The sensitivity and specificity of the automated system used to analyse the retinal fundal images was determined by comparison with optometric and ophthalmologic assessment.
The optometrists achieved 97 per cent sensitivity at 88 per cent specificity with respect to the ophthalmic classification for detecting retinopathy.
The automated retinopathy detector achieved 85 per cent sensitivity at 90 per cent specificity at detecting retinopathy. The automated microaneurysm detector has a lower sensitivity compared to the optometrists but meets NHMRC guidelines. It may impact on the efficiency of rural optometric practices by early identification of diabetic retinopathy. Automated assessment can save time and be cost-effective, and provide a history of changes in the retinal fundus and the opportunity for instant patient education using the digital images.
随着糖尿病患病率的上升，农村验光诊所的患者数量以及糖尿病眼病评估量可能会增加。本研究旨在评估基于微动脉瘤的存在对糖尿病视网膜病变进行自动识别在临床实践中是否是一种有效的工具。
我们分析了385例糖尿病患者的758张眼底图像，这些图像是使用佳能CR5相机和EOS10数码相机通过散瞳获得的，来自在该诊所就诊的患者。该诊所的五名验光师使用双目间接检眼镜对糖尿病视网膜病变进行评估。通过与验光和眼科评估相比较，确定用于分析视网膜眼底图像的自动系统的敏感性和特异性。
验光师在检测视网膜病变的眼科分类方面，敏感性达到97%，特异性为88%。
自动视网膜病变检测仪在检测视网膜病变时，敏感性为85%，特异性为90%。自动微动脉瘤检测仪与验光师相比敏感性较低，但符合澳大利亚国家卫生与医学研究委员会的指南。它可能通过早期识别糖尿病视网膜病变影响农村验光实践的效率。自动评估可以节省时间且具有成本效益，并提供视网膜眼底变化的历史记录以及利用数字图像对患者进行即时教育的机会。
