West S K, Rosenthal F, Newland H S, Taylor H R
Wilmer Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Invest Ophthalmol Vis Sci. 1988 Jan;29(1):73-7.
Methods for objectively documenting and grading different varieties of lens opacities are needed in order to conduct research on risk factors for cataracts. This study tested the feasibility and reliability of using two different photographic methods to grade nuclear opacities. Photographs were taken of 41 eyes using a regular Topcon SL-5D photo slit lamp, and using a Topcon SL-45 (Scheimpflug) camera. The photographs were graded against a set of four standard photographs of increasing nuclear opacification. Densitometric analyses were also performed on both sets of photographs. The clinical grade, on examination, of the nucleus was compared to the examiner's grade of each photograph. Agreement was fair between the examination results and the grading of the photographs. Inter-observer reliability was high (kappa = 0.71) with photographs taken using the photo slit lamp. Moreover, the severity grading of the photographs showed a good correlation with the severity of opacity as determined by densitometric analyses. On the basis of these data, and on the field experience, the use of photographs of the nucleus obtained by photo slit lamp may be used in epidemiological surveys.
为了开展白内障危险因素的研究，需要客观记录和分级不同类型晶状体混浊的方法。本研究测试了使用两种不同摄影方法对核混浊进行分级的可行性和可靠性。使用常规的拓普康SL - 5D照相裂隙灯和拓普康SL - 45（谢姆弗勒）相机对41只眼睛进行拍照。将这些照片与一组四张核混浊程度逐渐增加的标准照片进行分级对照。还对两组照片进行了密度测定分析。将检查时晶状体核的临床分级与检查者对每张照片的分级进行比较。检查结果与照片分级之间的一致性尚可。使用照相裂隙灯拍摄的照片观察者间可靠性较高（kappa = 0.71）。此外，照片的严重程度分级与密度测定分析确定的混浊严重程度显示出良好的相关性。基于这些数据以及现场经验，通过照相裂隙灯获得的晶状体核照片可用于流行病学调查。
