Inserm, Bordeaux Population Health Research Center, team LEHA, UMR 1219, Univ. Bordeaux, Bordeaux, France.
Department of Ophthalmology, Bordeaux University Hospital, Bordeaux, France.
Acta Ophthalmol. 2020 Nov;98(7):e830-e838. doi: 10.1111/aos.14422. Epub 2020 Apr 17.
To analyse and compare the prevalence of epiretinal membranes (ERMs) obtained using either standard retinal colour images or spectral-domain optical coherence tomography (SD-OCT) in a population-based setting of French elderly subjects.
Six hundred twenty-four subjects of the Alienor cohort aged 75 years or older underwent both colour fundus imaging and SD-OCT examinations. The ERMs were graded from retinal images and SD-OCT macular scans in a masked fashion. On SD-OCT images, the early ERMs, mature contractile ERMs without foveal modifications and mature contractile ERMs with foveal alterations were distinguished.
610 (97.8%) subjects had gradable SD-OCT examinations, and 511 (81.9%) had gradable fundus images in at least one eye. According to colour photographs, 11.6% of participants had definite ERMs. From SD-OCT images, 52.8% of the subjects had early ERMs, 7.4% had mature ERMs without foveal involvement, and 9.7% had mature ERMs with foveal alterations. Regardless of the imaging method used, the ERMs were more often observed in pseudophakic eyes than in phakic eyes. Comparison of ERM assessment using fundus photographs versus SD-OCT images demonstrated that the specificity of retinal colour images was good (>89.3%), whereas the sensitivity remained low even though it increased with ERM severity on SD-OCT images.
Spectral-domain optical coherence tomography (SD-OCT) examinations have high feasibility in this elderly population and are much more sensitive than standard colour images for ERM assessments, especially in the early stages of the disease. Our results further highlight the need to use SD-OCT instead of colour retinal photographs for the classification of ERMs in epidemiological studies.
在法国老年人群体中，分析和比较使用标准视网膜彩色图像或谱域光相干断层扫描（SD-OCT）获得的视网膜内界膜（ERM）的患病率。
Alienor 队列中 624 名 75 岁或以上的受试者同时接受彩色眼底成像和 SD-OCT 检查。ERM 分级采用盲法对视网膜图像和 SD-OCT 黄斑扫描进行。在 SD-OCT 图像上，可区分早期 ERM、无黄斑改变的成熟收缩性 ERM 和有黄斑改变的成熟收缩性 ERM。
610 名（97.8%）受试者的 SD-OCT 检查可分级，511 名（81.9%）至少一眼的眼底图像可分级。根据彩色照片，11.6%的参与者有明确的 ERM。从 SD-OCT 图像上看，52.8%的受试者有早期 ERM，7.4%的受试者有不伴有黄斑受累的成熟 ERM，9.7%的受试者有伴有黄斑改变的成熟 ERM。无论使用哪种成像方法，后房型人工晶状体眼的 ERM 比晶状体眼更常见。使用眼底照片和 SD-OCT 图像评估 ERM 的比较表明，视网膜彩色图像的特异性较好（>89.3%），尽管随着 SD-OCT 图像上 ERM 严重程度的增加而敏感性增加，但仍较低。
在这个老年人群中，谱域光相干断层扫描（SD-OCT）检查具有很高的可行性，并且对于 ERM 评估比标准彩色图像更敏感，尤其是在疾病的早期阶段。我们的结果进一步强调了在流行病学研究中需要使用 SD-OCT 而不是彩色眼底照片对 ERM 进行分类。
