Department of Ophthalmology, Columbia University College of Physicians and Surgeons, New York, NY 10032, USA.
Am J Ophthalmol. 2010 Oct;150(4):468-475.e2. doi: 10.1016/j.ajo.2010.04.027.
To examine the relationship between rate of vascular change and plus disease diagnosis.
Retrospective observational case-control study.
Wide-angle images were taken bilaterally from 37 infants at 31 to 33 weeks and 35 to 37 weeks postmenstrual age (PMA). The semi-automated Retinal Image multiScale Analysis system was used to measure parameters for all arteries and veins: integrated curvature, diameter, and tortuosity index. A reference standard diagnosis (plus vs not plus) was defined for each eye by consensus of 5 experts at 35 to 37 weeks PMA. Weekly rate of change in parameters was compared in eyes with plus vs not plus disease. Receiver operating characteristic area under the curve (AUC) was calculated for plus disease detection based on 1) weekly rates of parameter change between 31 to 33 weeks and 35 to 37 weeks PMA and 2) parameter values at 35 to 37 weeks only.
Weekly rates of change in all venous parameters were significantly different in eyes with plus vs not plus disease, particularly for tortuosity index (P < .0004) and diameter (P = .018). Using weekly rate of change, AUC for plus disease detection was highest for venous tortuosity index (0.819) and venous diameter (0.712). Using the 35 to 37-week PMA image only, AUC was highest for venous integrated curvature (0.952) and diameter (0.789).
Rate of change in venous, but not arterial, parameters is correlated with plus disease development in this data set. This did not appear to contribute information beyond analysis of an image at 35 to 37 weeks PMA only.
研究血管变化率与 plus 病诊断的关系。
回顾性观察性病例对照研究。
对 37 名胎龄 31 至 33 周和 35 至 37 周的婴儿双侧拍摄广角图像。使用视网膜图像多尺度分析系统半自动测量所有动静脉的参数：整合曲率、直径和扭曲指数。在 35 至 37 周胎龄时，通过 5 位专家的共识，为每只眼睛定义参考标准诊断（plus 或 not plus）。比较 plus 病与非 plus 病眼的参数每周变化率。基于 1）31 至 33 周和 35 至 37 周胎龄之间参数每周变化率和 2）仅在 35 至 37 周时的参数值，计算 plus 病检测的接收者操作特征曲线下面积（AUC）。
plus 病眼与非 plus 病眼的所有静脉参数每周变化率差异均有统计学意义，尤其是扭曲指数（P<0.0004）和直径（P=0.018）。使用每周变化率，静脉扭曲指数（AUC 为 0.819）和静脉直径（AUC 为 0.712）对 plus 病检测的 AUC 最高。仅使用 35 至 37 周胎龄的图像，静脉整合曲率（AUC 为 0.952）和直径（AUC 为 0.789）的 AUC 最高。
在本数据集，静脉参数的变化率与 plus 病的发展相关，但动脉参数无此相关性。这似乎并没有提供超出仅在 35 至 37 周胎龄时分析图像的信息。
