Hernández-Martínez Carmen, Palazón-Bru Antonio, Azrak Cesar, Navarro-Navarro Aída, Baeza-Díaz Manuel Vicente, Martínez-Toldos José Juan, Gil-Guillén Vicente Francisco
Ophthalmology Service, General Hospital of Elche , Elche, Alicante , Spain.
Department of Clinical Medicine, Miguel Hernández University , San Juan de Alicante, Alicante , Spain ; Research Unit, Elda Hospital , Elda, Alicante , Spain.
PeerJ. 2015 Nov 10;3:e1394. doi: 10.7717/peerj.1394. eCollection 2015.
No studies have yet evaluated jointly central foveal thickness (CFT) and the presence of intraretinal fluid (PIF) to diagnose diabetic macular oedema (DMO) using optic coherence tomography (OCT). We performed a cross-sectional observational study to validate OCT for the diagnosis of DMO using both CFT and PIF assessed by OCT (3D OCT-1 Maestro). A sample of 277 eyes from primary care diabetic patients was assessed in a Spanish region in 2014.
DMO diagnosed by stereoscopic mydriatic fundoscopy. OCT was used to measure CFT and PIF. A binary logistic regression model was constructed to predict the outcome using CFT and PIF. The area under the ROC curve (AUC) of the model was calculated and non-linear equations used to determine which CFT values had a high probability of the outcome (positive test), distinguishing between the presence or absence of PIF. Calculations were made of the sensitivity, specificity, and the positive (PLR) and negative (NLR) likelihood ratios. The model was validated using bootstrapping methodology. A total of 37 eyes had DMO. AUC: 0.88. Positive test: CFT ≥90 µm plus PIF (≥310 µm if no PIF). Clinical parameters: sensitivity, 0.83; specificity, 0.89; PLR, 7.34; NLR, 0.19. The parameters in the validation were similar. In conclusion, combining PIF and CFT provided a tool to very precisely discriminate the presence of DMO. Similar studies are needed to provide greater scientific evidence for the use of PIF in the diagnosis of DMO.
尚无研究联合评估中心凹厚度（CFT）和视网膜内液的存在情况（PIF），以利用光学相干断层扫描（OCT）诊断糖尿病性黄斑水肿（DMO）。我们进行了一项横断面观察性研究，以验证使用OCT（3D OCT - 1 Maestro）评估的CFT和PIF来诊断DMO的OCT方法。2014年在西班牙一个地区对来自基层医疗糖尿病患者的277只眼进行了抽样评估。
通过立体散瞳眼底镜检查诊断DMO。使用OCT测量CFT和PIF。构建二元逻辑回归模型，以使用CFT和PIF预测结果。计算模型的ROC曲线下面积（AUC），并使用非线性方程确定哪些CFT值具有高概率的结果（阳性检测），区分PIF的存在与否。计算敏感性、特异性以及阳性（PLR）和阴性（NLR）似然比。使用自举法对模型进行验证。共有37只眼患有DMO。AUC：0.88。阳性检测：CFT≥90 µm加PIF（若无PIF则≥310 µm）。临床参数：敏感性为0.83；特异性为0.89；PLR为7.34；NLR为0.19。验证中的参数相似。总之，结合PIF和CFT提供了一种非常精确地区分DMO存在情况的工具。需要进行类似研究，为在DMO诊断中使用PIF提供更多科学证据。
