糖尿病性黄斑水肿的光凝治疗中的变异性。
Variability in photocoagulation treatment of diabetic macular oedema.
机构信息
Department of Ophthalmology, Academic Medical Center, Amsterdam, the NetherlandsDepartment of Biomedical Engineering and Physics, Academic Medical Center, Amsterdam, the NetherlandsDepartment of Clinical and Molecular Ophthalmogenetics, The Netherlands Institute for Neuroscience, Royal Netherlands Academy of Arts and Sciences (KNAW), Amsterdam, the NetherlandsDepartment of Ophthalmology and Visual Sciences, The University of Iowa Hospital and Clinics, Iowa City, Iowa, USADepartment of Veterans Affairs, Iowa City, Iowa, USADepartment of Electrical and Computer Engineering, The University of Iowa, Iowa City, Iowa, USA.
出版信息
Acta Ophthalmol. 2013 Dec;91(8):722-7. doi: 10.1111/j.1755-3768.2012.02524.x. Epub 2012 Sep 13.
PURPOSE
To establish whether differences in the assessment of diabetic macular oedema (DME) with either optical coherence tomography (OCT) or stereoscopic biomicroscopy lead to variability in the photocoagulation treatment of DME.
METHODS
The differences in the assessment of DME with either OCT or stereoscopic biomicroscopy were analysed by calculating the surface areas and the overlap of retinal thickening. Photocoagulation treatment plans of retinal specialists were compared by evaluating the number and location of planned laser spots.
RESULTS
The threshold for and dosage of photocoagulation differ depending upon whether the basis of retinal thickness diagnosis is clinical observation or OCT. The overlap in laser spot location based on the assessment of DME with OCT or biomicroscopy averages 51%. Among retinal specialists, the treatment plans differed in the laser spot count by six- to 11-fold.
CONCLUSION
Diabetic macular oedema photocoagulation treatment threshold and dosage of laser spots differ depending on whether thickness assessments are based on stereoscopic slit-lamp biomicroscopy or OCT. In addition, retinal specialists differed in the number and placement of planned laser spots even when given identical information concerning DME and treatable lesions. This variability in the photocoagulation treatment of DME could lead to differences in patient outcome and laser study results.
目的
探讨应用光学相干断层扫描（OCT）或立体体视显微镜评估糖尿病性黄斑水肿（DME）的差异是否会导致 DME 光凝治疗的变异性。
方法
通过计算视网膜增厚的表面积和重叠来分析 OCT 或立体体视显微镜评估 DME 的差异。通过评估计划激光点的数量和位置来比较视网膜专家的光凝治疗计划。
结果
基于视网膜厚度诊断的基础是临床观察还是 OCT，光凝治疗的阈值和剂量会有所不同。基于 OCT 或体视显微镜评估 DME 的激光点位置重叠平均为 51%。在视网膜专家中，激光点计数的治疗计划差异为 6 至 11 倍。
结论
糖尿病性黄斑水肿光凝治疗的阈值和激光点剂量取决于厚度评估是基于立体裂隙灯显微镜还是 OCT。此外，即使给予关于 DME 和可治疗病变的相同信息，视网膜专家在计划激光点的数量和位置上也存在差异。这种 DME 光凝治疗的变异性可能导致患者结果和激光研究结果的差异。
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