Cheng Sam C K, Yap Maurice K H, Goldschmidt Ernest, Swann Peter G, Ng Larry H Y, Lam Carly S Y
Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hong Kong.
Clin Exp Optom. 2008 Jul;91(4):373-8. doi: 10.1111/j.1444-0938.2007.00231.x.
Optomap uses the ultra-wide field scanning laser ophthalmoscopy to provide retinal examination. It permits fundus examination without the use of a mydriatic, which is more comfortable for the patients. This paper determines the sensitivity and specificity of the Optomap for detecting retinal signs under non-mydriatic conditions.
Fifty-four eyes identified with retinal/choroidal signs and eight normal eyes were recruited from 31 Hong Kong Chinese subjects. Photo-documentation of fundal changes was obtained with the Optomap under non-mydriatic conditions before a dilated fundus examination by a clinician using standard procedures. The eyelid was retracted using a cotton bud when necessary. Dilated fundus examinations were performed by another clinician using binocular indirect ophthalmoscopy and slitlamp biomicroscopy with a fundus lens. The Optomap images were evaluated by four other investigators under masked condition. The International Classification of Disease, Ninth Revision (ICD-9-CM) was adopted for recording retinal features. Screening results were compared with those obtained using the dilated fundus examination as the gold standard.
The cotton bud method for eyelid retraction showed an improvement in the area of retina that could be visualised. The sensitivity and specificity of the Optomap averaged 76.4 and 71.9 per cent, respectively. Some fundal signs were missed by all observers in the Optomap but not with the biomicroscope. These included white-without-pressure, lattice degeneration, paramacular drusen and pigmentary changes at central fundus.
Optomap serves as a reliable screening tool for fundus examination especially because it covers a much wider area of the peripheral retina than other digital instruments for fundus photography.
Optomap采用超广角扫描激光检眼镜进行视网膜检查。它无需使用散瞳剂即可进行眼底检查，这对患者来说更舒适。本文旨在确定Optomap在非散瞳条件下检测视网膜体征的敏感性和特异性。
从31名中国香港受试者中招募了54只患有视网膜/脉络膜体征的眼睛和8只正常眼睛。在临床医生使用标准程序进行散瞳眼底检查之前，先在非散瞳条件下用Optomap对眼底变化进行拍照记录。必要时用棉签牵拉眼睑。另一位临床医生使用双目间接检眼镜和带眼底镜的裂隙灯显微镜进行散瞳眼底检查。Optomap图像由另外四名研究人员在盲态下进行评估。采用国际疾病分类第九版（ICD-9-CM）记录视网膜特征。将筛查结果与以散瞳眼底检查作为金标准所获得的结果进行比较。
棉签牵拉眼睑的方法使可观察到的视网膜面积有所增加。Optomap的敏感性和特异性平均分别为76.4%和71.9%。Optomap检查中所有观察者都遗漏了一些眼底体征，但在生物显微镜检查中未遗漏。这些体征包括无压力白色病变、格子样变性、黄斑旁玻璃膜疣和眼底中央色素改变。
Optomap可作为一种可靠的眼底筛查工具，特别是因为它比其他眼底摄影数字仪器能覆盖更广阔的周边视网膜区域。
