Terasaki Hiroto, Sonoda Shozo, Kakiuchi Naoko, Shiihara Hideki, Yamashita Takehiro, Sakamoto Taiji
Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan.
BMC Ophthalmol. 2018 Dec 17;18(1):324. doi: 10.1186/s12886-018-0995-8.
To compare the ability of ocular fundus images obtained by Spectralis MultiColor scanning laser ophthalmoscope (MC-SLO) to that obtained by conventional color fundus images (CF) in detecting non-glaucomatous nerve fiber layer defects (NFLDs).
A cross-sectional, retrospective study. Patients with retinal diseases who had ocular examination with both the MC-SLO and CF instruments at the Kagoshima University from December 2016 to February 2017 were studied. Eyes that had NFLDs with non-glaucomatous optic discs were analyzed. The visibility of the NFLDs was classified into three grades: grade 0, not visible; grade 1, barely visible; and grade 2, clearly visible. The NFLD grade for blue, green, and red scanning lights of the MC-SLO, merged images with three wavelengths and the color and red-free images were determined by two ophthalmologists. These scores were compared by Steel-Dwass tests.
Thirty-one eyes of 26 patients with a mean age of 63.1 ± 11.2 years were studied. There were 14 eyes with diabetic retinopathy, 11 eyes with age-related macular degeneration, 3 eyes with a branch retinal vein occlusion, and 3 eyes with an epiretinal membrane/macular hole. Both the intra-rater (0.631-0.790) and inter-rater (0.637-0.733) agreements were good. NFLDs were detected by the blue wavelength in all cases and by green wavelength and merged wavelengths in 90.3% of the images. The mean NFLD grade was 1.58 ± 0.49 for blue light images, 1.13 ± 0.54 for green light images, 0.07 ± 0.24 for red light images, and 1.16 ± 0.56 for merged images. The NFLD score for blue wavelength was significantly higher than that for green and red wavelength images (P < 0.05 and P < 0.01) but not significantly higher than that for the merged images. NFLDs were detected in 12 eyes (38.7%) in the color images and 16 eyes (51.6%) in the red-free images. The NFLD score for the CF and the red-free image was 0.41 ± 0.55 and 0.70 ± 0.67 which is significantly lower than that of blue MC-SLO images.
The images obtained by MC-SLO are superior to that obtained by CF in detecting NFLDs in eyes with retinal diseases. We recommend MC-SLO imaging to screen for NFLDs in eyes with retinal diseases.
比较使用Spectralis多色扫描激光检眼镜（MC-SLO）获得的眼底图像与传统彩色眼底图像（CF）在检测非青光眼性神经纤维层缺损（NFLD）方面的能力。
一项横断面回顾性研究。对2016年12月至2017年2月在鹿儿岛大学同时使用MC-SLO和CF仪器进行眼部检查的视网膜疾病患者进行研究。分析具有非青光眼性视盘的NFLD眼睛。NFLD的可见性分为三个等级：0级，不可见；1级，勉强可见；2级，清晰可见。由两位眼科医生确定MC-SLO的蓝色、绿色和红色扫描光、三种波长的合并图像以及彩色和无赤图像的NFLD等级。这些分数通过Steel-Dwass检验进行比较。
研究了26例患者的31只眼睛，平均年龄为63.1±11.2岁。其中有14只眼睛患有糖尿病性视网膜病变，11只眼睛患有年龄相关性黄斑变性，3只眼睛患有视网膜分支静脉阻塞，3只眼睛患有视网膜前膜/黄斑裂孔。评分者内一致性（0.631 - 0.790）和评分者间一致性（0.637 - 0.733）均良好。在所有病例中，蓝色波长均能检测到NFLD，90.3%的图像中绿色波长和合并波长也能检测到。蓝光图像的平均NFLD等级为1.58±0.49，绿光图像为1.13±0.54，红光图像为0.07±0.24，合并图像为1.16±0.56。蓝色波长的NFLD评分显著高于绿色和红色波长图像（P < 0.05和P < 0.01），但不显著高于合并图像。彩色图像中12只眼睛（38.7%）检测到NFLD，无赤图像中16只眼睛（51.6%）检测到NFLD。CF和无赤图像的NFLD评分为0.41±0.55和0.70±0.67，显著低于蓝色MC-SLO图像。
在检测视网膜疾病患者眼睛中的NFLD方面，MC-SLO获得的图像优于CF获得的图像。我们建议使用MC-SLO成像来筛查视网膜疾病患者眼睛中的NFLD。
