视网膜疾病筛查研究：非散瞳眼底照相术与光学相干断层扫描对视盘不规则性检测的前瞻性比较
The retinal disease screening study: prospective comparison of nonmydriatic fundus photography and optical coherence tomography for detection of retinal irregularities.
机构信息
Doheny Eye Institute and Department of Ophthalmology, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA.
出版信息
Invest Ophthalmol Vis Sci. 2013 Feb 19;54(2):1460-8. doi: 10.1167/iovs.12-10727.
PURPOSE
To compare the sensitivity of volume scanning with optical coherence tomography (OCT) to nonmydriatic color fundus photography (FP) for the detection of retinal irregularities in asymptomatic populations.
METHODS
Asymptomatic subjects without known ocular disease were recruited over a 6-month period. For each eye, two undilated 45° fundus images and four undilated volume OCT image sets covering the macula and optic nerve were obtained. Color images were evaluated for irregularities both inside and outside the area covered by OCT. OCT image sets were evaluated for internal limiting membrane irregularities, abnormal retinal thickness, hyper/hyporeflective features, and photoreceptor/retinal pigment epithelium (RPE) irregularities. Detection sensitivities were compared and false-negative cases were analyzed.
RESULTS
A total of 284 eyes (144 subjects) were included, with a mean age of 38.1 years (range 18-77). Among 253 eyes (135 subjects) with gradable images from both FP and OCTs, the detection sensitivities for OCT were higher (96.2% infield and 85.7% in full field) than for FP (19.9% infield and 43.8% in full field) for all irregularities evaluated in the study (including epiretinal irregularities, abnormal retinal thickness, intraretinal hyperreflective/hyporeflective features, and photoreceptor/RPE irregularities). Overall, the presence of definite irregularities on either fundus imaging or OCT by eye in this asymptomatic population was 42.6% (121/284), with 39.4% (112/284) of eyes having RPE irregularities such as drusen.
CONCLUSIONS
For detection of a variety of retinal irregularities evaluated in the current study, volume OCT scanning was more sensitive than nonmydriatic retinal photography in our asymptomatic individuals. OCT detected clinically relevant disease features, such as subretinal fluid, that were missed by FP, and had a lower ungradable image rate. It is likely that OCT will be added to photography screening in the near future for chorioretinal disease.
目的
比较体积扫描光学相干断层扫描（OCT）与非散瞳眼底彩色照相（FP）检测无症状人群视网膜不规则性的敏感性。
方法
在 6 个月的时间内招募了无症状、无已知眼部疾病的受试者。对每只眼，均获取了两个未散瞳的 45°眼底图像和覆盖黄斑和视神经的四个未散瞳的 OCT 图像。对彩色图像进行 OCT 区域内外不规则性的评估。对 OCT 图像进行内界膜不规则、视网膜异常增厚、高/低反射特征和光感受器/视网膜色素上皮（RPE）不规则的评估。比较了检测灵敏度并分析了假阴性病例。
结果
共纳入 284 只眼（144 例），平均年龄为 38.1 岁（18-77 岁）。在 253 只可评估 FP 和 OCT 图像的眼中，OCT 的检测灵敏度更高（场内 96.2%，全场 85.7%），而 FP 的检测灵敏度较低（场内 19.9%，全场 43.8%），所有评估的不规则性（包括视网膜表面不规则、视网膜异常增厚、视网膜内高反射/低反射特征和光感受器/RPE 不规则）。总的来说，在这个无症状人群中，每只眼通过眼底成像或 OCT 检测到确定的不规则性的比例为 42.6%（121/284），其中 39.4%（112/284）的眼存在 RPE 不规则，如 drusen。
结论
在我们的无症状个体中，与非散瞳眼底摄影相比，体积 OCT 扫描对于评估的各种视网膜不规则性的检测更敏感。OCT 检测到了 FP 遗漏的与临床相关的疾病特征，如视网膜下液，并且未分级图像的比例更低。OCT 很可能会在不久的将来被添加到眼底摄影筛查中，用于检查脉络膜视网膜疾病。
Zotero 插件