Yasar Erdogan, Yildirim Nilgun, Atalay Eray, Tambova Emre, Colak Ertugrul
*MD Aksaray University Training and Research Hospital, Aksaray (EY); Eskisehir Osmangazi University Medical School, Eskisehir (NY, EC); Derindere Hospital, Istanbul (EA); and Bilecik State Hospital, Bilecik, Turkey (ET).
Optom Vis Sci. 2017 Jul;94(7):770-774. doi: 10.1097/OPX.0000000000001092.
Our objective was to evaluate the diagnostic value of a handheld pupillometer in differentiating eyes with pseudoexfoliation syndrome (PXS) from healthy controls.
This population-based, cross-sectional study was conducted in the province of Eskisehir, Turkey. Subjects 40 years of age and older were randomly recruited using stratified two-stage cluster sampling from the database of the Turkish Statistical Institute office in Eskisehir. Recruitment took place between June and October 2014. The inclusion criteria were healthy subjects who did not have a previous diagnosis of glaucoma or other issues affecting pupil dynamics. After an extensive ophthalmic examination, pupillometry was performed under standard photopic room lighting conditions. After pupillometry, the pupil was dilated and digital images of the anterior segment were taken for confirmation of PXS. An inter-eye pupil diameter difference of ≥0.4 mm was defined as pupil asymmetry.
Of the 2356 invited subjects, 2017 agreed to participate (85.6%), and 1559 subjects were eligible for the study. An age-matched subgroup consisting of 529 healthy controls was randomly selected to compare with the 60 subjects who were diagnosed with PXS. The mean pupil diameters of subjects with PXS and healthy controls were 3.57 ± 0.68 mm and 3.68 ± 0.63 mm, respectively (P = .652). In the ROC analysis, the precision of pupil diameter in discriminating PXS was low (AUC 0.56, sensitivity 14%, specificity 94%). Pupil asymmetry increased the chances of having PXS by 3.46-fold.
Pupillometry performed poorly in the detection of PXS scoring a positive predictive value of 26%.
我们的目标是评估手持式瞳孔计在鉴别假性剥脱综合征（PXS）患者与健康对照者眼睛方面的诊断价值。
这项基于人群的横断面研究在土耳其埃斯基谢希尔省进行。采用分层两阶段整群抽样方法，从埃斯基谢希尔土耳其统计局办公室的数据库中随机招募40岁及以上的受试者。招募工作于2014年6月至10月进行。纳入标准为既往未被诊断患有青光眼或其他影响瞳孔动态的疾病的健康受试者。经过全面的眼科检查后，在标准明视室内照明条件下进行瞳孔测量。瞳孔测量后，散瞳并拍摄眼前节的数字图像以确诊PXS。双眼瞳孔直径差值≥0.4mm被定义为瞳孔不对称。
在2356名受邀受试者中，2017人同意参与（85.6%），1559名受试者符合研究条件。随机选取了由529名健康对照组成的年龄匹配亚组，与60名被诊断为PXS的受试者进行比较。PXS患者和健康对照者的平均瞳孔直径分别为3.57±0.68mm和3.68±0.63mm（P = 0.652）。在ROC分析中，瞳孔直径鉴别PXS的准确性较低（AUC 0.56，敏感性14%，特异性94%）。瞳孔不对称使患PXS的几率增加了3.46倍。
瞳孔测量在检测PXS方面表现不佳，阳性预测值为26%。
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