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葡萄膜炎中的增强深度成像光学相干断层扫描:一项就诊期间及观察者间可重复性研究

Enhanced Depth Imaging Optical Coherence Tomography in Uveitis: An Intravisit and Interobserver Reproducibility Study.

作者信息

Kim Jane S, Knickelbein Jared E, Jaworski Laurence, Kaushal Padmini, Vitale Susan, Nussenblatt Robert B, Sen H Nida

机构信息

University of California, San Diego, School of Medicine, La Jolla, California; Laboratory of Immunology, National Eye Institute, National Institutes of Health, Bethesda, Maryland.

Laboratory of Immunology, National Eye Institute, National Institutes of Health, Bethesda, Maryland.

出版信息

Am J Ophthalmol. 2016 Apr;164:49-56. doi: 10.1016/j.ajo.2016.01.004. Epub 2016 Jan 29.

Abstract

PURPOSE

To determine the intravisit and interobserver reproducibility of subfoveal choroidal thickness (SFCT) measurements in patients with noninfectious uveitis.

DESIGN

Reliability analysis.

METHODS

Two consecutive enhanced depth imaging optical coherence tomography (EDI-OCT) scans were obtained at a single clinic visit for 97 uveitic eyes from patients ≥16 years of age with noninfectious anterior (n = 10), intermediate (n = 11), posterior (n = 26), and panuveitis (n = 13) at the National Eye Institute. SFCT was manually measured by 2 ophthalmologists using manufacturer's software. Intravisit and interobserver reproducibility of SFCT measurements were assessed by using the Bland-Altman method to determine the estimate of bias (mean difference in SFCT measurements), 95% limits of agreement, and coefficients of repeatability. The reproducibility of these measurements was also compared between groups by anatomic location and clinical activity.

RESULTS

Of 97 eyes, 65 (67.0%) were clinically quiet, 18 (18.6%) were minimally active, and 14 (14.4%) were active at the time the scans were obtained. Manual SFCT measurements were reproducible within 32.4 ± 3.8 μm between sessions for the same observer and 51.4 ± 8.5 μm between observers for the same session. Coefficients of repeatability did not differ significantly by anatomic location or disease activity.

CONCLUSIONS

Manual SFCT measurements obtained by EDI-OCT are reproducible in uveitis patients, with coefficients of repeatability that are nearly comparable to those published for normal eyes. This study provides guidance for using manual SFCT measurements in clinical practice, but further studies are still needed to determine their utility in clinical trials.

摘要

目的

确定非感染性葡萄膜炎患者黄斑中心凹下脉络膜厚度(SFCT)测量的单次就诊及观察者间的可重复性。

设计

可靠性分析。

方法

在国立眼科研究所,对97例年龄≥16岁的非感染性前葡萄膜炎(n = 10)、中间葡萄膜炎(n = 11)、后葡萄膜炎(n = 26)和全葡萄膜炎(n = 13)患者的患眼,在单次就诊时连续进行两次增强深度成像光学相干断层扫描(EDI-OCT)。由两名眼科医生使用厂家软件手动测量SFCT。采用Bland-Altman方法评估SFCT测量的单次就诊及观察者间的可重复性,以确定偏差估计值(SFCT测量的平均差值)、95%一致性界限和重复性系数。还根据解剖位置和临床活动情况对不同组之间这些测量的可重复性进行了比较。

结果

在扫描时,97只眼中65只(67.0%)临床静止,18只(18.6%)轻度活动,14只(14.4%)活动。对于同一观察者,两次测量之间手动测量的SFCT可重复性在32.4±3.8μm以内;对于同一就诊的不同观察者,可重复性在51.4±8.5μm以内。重复性系数在解剖位置或疾病活动方面无显著差异。

结论

EDI-OCT获得的手动SFCT测量在葡萄膜炎患者中具有可重复性,其重复性系数与正常眼报道的系数相近。本研究为临床实践中使用手动SFCT测量提供了指导,但仍需进一步研究以确定其在临床试验中的效用。

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