Tugal-Tutkun Ilknur, Onal Sumru, Ozyazgan Yilmaz, Soylu Merih, Akman Mehmet
Department of Ophthalmology, Istanbul University, Istanbul Medical Faculty , Istanbul , Turkey .
Ocul Immunol Inflamm. 2014 Dec;22(6):461-8. doi: 10.3109/09273948.2013.854393. Epub 2013 Dec 11.
Abstract Purpose: To evaluate agreement and estimate sensitivity and specificity of uveitis specialists' interpretation of ocular photographs in diagnosing Behçet uveitis.
Fourteen Turkish uveitis specialists, masked to demographic and clinical features of patients, independently labeled ocular photographs (29 Behçet/30 other diagnoses) as "Behçet uveitis" or "non-Behçet." Level of agreement was evaluated using kappa statistics. Photographs were categorized based on ocular signs captured and performance of observers.
Exact agreement with the correct diagnosis was 56-81%. Seven reviewers correctly labeled more than 70% of photographs. Interobserver agreement among those 7 reviewers revealed moderate (κ = 0.41-0.60) or substantial (κ = 0.61-0.80) agreement in 76% of pairs. Smooth layered hypopyon, superficial retinal infiltrate with retinal hemorrhages, and branch retinal vein occlusion with vitreous haze were correctly recognized as Behçet uveitis by majority of reviewers.
There are ocular signs of Behçet disease that can be considered diagnostic even in the absence of any other clinical information.
摘要 目的：评估葡萄膜炎专家对眼部照片进行解读以诊断白塞氏葡萄膜炎时的一致性，并估计其敏感性和特异性。
14名土耳其葡萄膜炎专家，在对患者的人口统计学和临床特征不知情的情况下，独立将眼部照片（29例白塞氏/30例其他诊断）标记为“白塞氏葡萄膜炎”或“非白塞氏”。使用kappa统计量评估一致性水平。根据所捕捉到的眼部体征和观察者的表现对照片进行分类。
与正确诊断的完全一致性为56%-81%。7名评审员正确标记了超过70%的照片。这7名评审员之间的观察者间一致性显示，76%的配对具有中度（κ = 0.41-0.60）或高度（κ = 0.61-0.80）一致性。多数评审员正确地将光滑分层的前房积脓、伴有视网膜出血的浅层视网膜浸润以及伴有玻璃体混浊的视网膜分支静脉阻塞识别为白塞氏葡萄膜炎。
即使在没有任何其他临床信息的情况下，白塞氏病的某些眼部体征也可被视为具有诊断意义。
