Department of Retina and Vitreous, Narayana Nethralaya, Bengaluru, Karnataka, India.
Department of Cornea and Refractive Surgery, Narayana Nethralaya, Bengaluru, Karnataka, India.
Indian J Ophthalmol. 2020 Dec;68(12):2930-2934. doi: 10.4103/ijo.IJO_2239_20.
The aim of this study was to compute the sensitivity, specificity and inter-reader variability of ultra-widefield retinal imaging (Optomap 200Tx) for screening retinal lesions before myopic refractive surgery.
Two hundred and eight eyes of 109 consecutive refractive surgery candidates were included in this study. All subjects underwent Optomap 200Tx, mydriatic slit-lamp lens examination and dilated retinal examination with scleral indentation by a retinal specialist. Retinal findings by indirect dilated examination by retinal specialist was considered as the gold-standard. Sensitivity analyses for the readers were calculated between the Optomap images and the gold-standard retinal examination.
Seventy-three of the 208 eyes (35.1%) had peripheral retinal lesions diagnosed by the retinal specialist on dilated fundus examination. Peripheral lesions were seen on the Optomap images in 111 (53.4%) eyes. Compared to the dilated retinal examination, the detection rate with the Optomap 200Tx was 78.1% and specificity rate was 60%. The accuracy rate between the 3 readers ranged from 72% to 87%. The highest accuracy was noted with the reader post 1 year of retinal training (86.54%).
The Optomap 200Tx showed a high sensitivity and moderate specificity for identifying peripheral retinal lesions in eyes undergoing refractive surgery. The Optomap examination is a convenient, fast and feasible method for detecting the pathological fundus changes in myopic eyes. The reliability of the examination improves when the images are interpreted by a reader with prior retinal training.
本研究旨在计算超广角视网膜成像（Optomap 200Tx）在近视屈光手术前筛查视网膜病变的敏感性、特异性和读者间变异性。
本研究纳入了 109 例连续屈光手术候选者的 208 只眼。所有受试者均接受 Optomap 200Tx、散瞳裂隙灯检查和视网膜专家用巩膜压陷法进行散瞳视网膜检查。以视网膜专家进行的间接散瞳检查的视网膜发现作为金标准。对读者进行了 Optomap 图像与金标准视网膜检查之间的敏感性分析。
73 只（35.1%）208 只眼中的视网膜周边病变在散瞳眼底检查中被视网膜专家诊断。111 只（53.4%）眼中的 Optomap 图像上可见周边病变。与散瞳视网膜检查相比，Optomap 200Tx 的检出率为 78.1%，特异性为 60%。3 位读者的准确率范围为 72%至 87%。经过 1 年视网膜培训的读者的准确率最高（86.54%）。
Optomap 200Tx 对识别屈光手术眼的周边视网膜病变具有较高的敏感性和中等的特异性。Optomap 检查是一种方便、快速和可行的方法，可用于检测近视眼中的病理性眼底改变。当由具有视网膜培训经验的读者来解释图像时，检查的可靠性会提高。
