Kernt M, Pinter F, Hadi I, Hirneiss C, Haritoglou C, Kampik A, Ulbig M W, Neubauer A S
Augenklinik der Ludwig-Maximilians-Universität, München, Mathildenstrasse 8, 80336 München, Deutschland.
Ophthalmologe. 2011 Feb;108(2):117-23. doi: 10.1007/s00347-010-2226-4.
The aim of the study was to compare the diagnostic properties of a non-mydriatic 200° ultra-widefield scanning laser ophthalmoscope (SLO) with mydriatic ETDRS 7-field fundus photography for diabetic retinopathy screening.
A consecutive series of 66 eyes from 34 patients with different levels of diabetic retinopathy (DR) were examined. Grading of DR and macular edema (ME) obtained from mydriatic ETDRS 7-field fundus photography were compared with grading obtained from Optomap Panoramic 200MA SLO images. All SLOs were performed with an undilated pupil and no additional clinical information was used for evaluation of images by two independent, masked experts.
A total of 14 eyes from ETDRS 7-field fundus photography and 11 eyes from Optomap could not be graded by at least one grader due to poor image quality, yielding 48 eyes for comparison purposes. Of the 48 ETDRS 7-field fundus photographs, 9 (11 for grader 2) eyes had no or mild DR (ETDRS levels ≤20) and 17 (23 for grader 2) eyes had no ME. Agreement of Optomap retinopathy grading with ETDRS 7-field fundus photography was good, kappa 0.70 for grader 1 and kappa 0.66 for grader 2. There was good agreement between both techniques for ME, grader 1 kappa 0.68 and grader 2 kappa 0.74.
Grading of DR levels from Optomap Panoramic 200MA non-mydriatic images showed a good correlation with mydriatic ETDRS 7-field fundus photography. Both techniques are of sufficient quality for a valid assessment of DR. Optomap Panoramic 200MA images cover a larger retinal area and might therefore offer additional diagnostic properties.
本研究旨在比较非散瞳200°超广角扫描激光检眼镜(SLO)与散瞳ETDRS七视野眼底照相术在糖尿病视网膜病变筛查中的诊断性能。
对34例患有不同程度糖尿病视网膜病变(DR)的患者的66只眼睛进行连续检查。将散瞳ETDRS七视野眼底照相术得出的DR分级和黄斑水肿(ME)分级与Optomap全景200MA SLO图像得出的分级进行比较。所有SLO检查均在未散瞳的瞳孔下进行,且两位独立的、不知情的专家在评估图像时未使用其他临床信息。
由于图像质量差,ETDRS七视野眼底照相术的14只眼睛和Optomap的11只眼睛至少有一位分级者无法进行分级,因此有48只眼睛可用于比较。在48张ETDRS七视野眼底照片中,9只眼睛(分级者2为11只)无DR或患有轻度DR(ETDRS分级≤20),17只眼睛(分级者2为23只)无ME。Optomap视网膜病变分级与ETDRS七视野眼底照相术的一致性良好,分级者1的kappa值为0.70,分级者2的kappa值为0.66。两种技术在ME方面的一致性良好,分级者1的kappa值为0.68,分级者2的kappa值为0.74。
Optomap全景200MA非散瞳图像的DR分级与散瞳ETDRS七视野眼底照相术显示出良好的相关性。两种技术的质量都足以对DR进行有效评估。Optomap全景200MA图像覆盖的视网膜面积更大,因此可能具有额外的诊断性能。