Awad Catherine, Slotnick Samantha, Nath Sanjeev, Sherman Jerome
Nova Southeastern College of Optometry, Fort Lauderdale-Davie, FL.
SUNY State College of Optometry.
Eye Brain. 2013 Feb 13;5:9-21. doi: 10.2147/EB.S40322. eCollection 2013.
The purpose of this study was to assess the specificity and sensitivity of the iWellnessExam™ screening protocol available on iVue spectral domain optical coherence tomography (SD-OCT), in a cohort of confirmed normal subjects and subjects with confirmed disease.
In total, 126 of 132 confirmed normal subjects and 101 of 107 subjects with confirmed disease were included for analysis. Of the patients with confirmed disease, 67 had retinal disease, 50 had optic nerve disease, and 16 had both retinal and optic nerve pathology. All subjects were screened on the iWellnessExam protocol. Screen shots of the OD, OS, and OU comparison data were obtained and deidentified for reviewer analysis. Based on these data alone, each subject was sorted by a well trained eye care clinician into one of four categories (1, normal; 2, retinal disease; 3, optic nerve disease; 4, retinal and optic nerve disease).
Of the confirmed normal subjects, 125 of 126 were correctly identified as normal (specificity 99%). Retinal and/or optic nerve disease was correctly detected in 97 of 101 patients with confirmed disease (category 2, 3, 4), retinal pathology was correctly detected in 64 of 67 patients with retinal disease (category 2, 4), and optic nerve pathology was properly detected in 45 of 50 patients with optic nerve disease (category 3, 4), with a sensitivity of 96%, 95.5%, and 90%, respectively.
The iWellnessExam offers the health care provider an excellent method for identifying eyes at risk using very reliable technology. High specificity and sensitivity was obtained when reviewed by a well trained eye care clinician. It would be valuable to repeat the study with a novice and/or student clinician reviewing the same data set to ascertain interobserver variability, as well as the impact of clinical experience on accurate referral, based on the screening data.
本研究旨在评估iVue频域光学相干断层扫描（SD - OCT）上可用的iWellnessExam™筛查方案在一组确诊的正常受试者和确诊疾病受试者中的特异性和敏感性。
总共纳入了132名确诊正常受试者中的126名以及107名确诊疾病受试者中的101名进行分析。在确诊疾病的患者中，67例患有视网膜疾病，50例患有视神经疾病，16例同时患有视网膜和视神经病变。所有受试者均按照iWellnessExam方案进行筛查。获取了右眼（OD）、左眼（OS）和双眼（OU）比较数据的屏幕截图，并进行去识别处理以供审阅者分析。仅基于这些数据，由训练有素的眼科临床医生将每个受试者分为四类之一（1，正常；2，视网膜疾病；3，视神经疾病；4，视网膜和视神经疾病）。
在确诊的正常受试者中，126名中有125名被正确识别为正常（特异性99%）。101例确诊疾病患者（类别2、3、4）中有97例的视网膜和/或视神经疾病被正确检测到，67例视网膜疾病患者（类别2、4）中有64例的视网膜病变被正确检测到，50例视神经疾病患者（类别3、4）中有45例的视神经病变被正确检测到，敏感性分别为96%、95.5%和90%。
iWellnessExam为医疗保健提供者提供了一种使用非常可靠的技术识别有风险眼睛的出色方法。由训练有素的眼科临床医生进行审阅时，可获得高特异性和敏感性。重复该研究，让新手和/或学生临床医生审阅相同数据集，以确定观察者间的变异性以及临床经验对基于筛查数据的准确转诊的影响，将是很有价值的。
