视网膜脱离后的结构病理学：多光谱共焦激光扫描检眼镜与彩色眼底照相。

Department of Ophthalmology, Stavanger University Hospital, Stavanger, Norway.

Department of Quality and Health Technology, University of Stavanger, Stavanger, Norway.

Retina. 2021 Sep 1;41(9):1958-1965. doi: 10.1097/IAE.0000000000003113.

PURPOSE

To compare pathology detection using multicolor confocal scanning laser ophthalmoscopy with color fundus photography following macula-off rhegmatogenous retinal detachment.

METHODS

Postsurgery multicolor confocal scanning laser ophthalmoscopy and color fundus photography images from 30 rhegmatogenous retinal detachment patients were examined by 10 masked graders. Imaging was performed with the Heidelberg Spectralis HRA and the digital retinal camera Basler acA2500-14gc GigE. Swept-source optical coherence tomography was used as verification modality. Detection rates of ellipsoid zone disruption, foveal ellipsoid zone rosette, outer retinal folds, intraretinal cysts, subretinal fluid layer, subretinal fluid blebs, retinal striae, and retinal detachment line were compared. Intermodality and intergrader agreement were estimated.

RESULTS

Overall pathology detection was significantly higher for multicolor confocal scanning laser ophthalmoscopy multicolor confocal scanning laser ophthalmoscopy (adjusted odds ratio = 7.39; 95% confidence interval, 1.64-33.30; P = 0.009). The intermodality and intergrader agreement on overall pathology detection were moderate. The intermodality agreement was 0.49 (95% confidence interval, 0.48-0.51; P < 0.0001) (Gwet's AC1). Intergrader agreement was 0.53 (95% confidence interval, 0.52-0.54; P < 0.0001) for multicolor confocal scanning laser ophthalmoscopy and 0.58 (95% confidence interval, 0.57-0.59; P < 0.0001) (Fleiss kappa) for color fundus photography.

CONCLUSION

Multicolor confocal scanning laser ophthalmoscopy imaging is superior to color fundus photography in detecting and delineating structural retinal abnormalities following rhegmatogenous retinal detachment and can be a helpful tool in the visualization of retinal remodeling processes in patients recovering from rhegmatogenous retinal detachment surgery.

目的

比较黄斑裂孔性视网膜脱离术后多色共焦激光扫描检眼镜与眼底彩色照相检查的病理学检测结果。

方法

对 30 例孔源性视网膜脱离患者的术后多色共焦激光扫描检眼镜和眼底彩色照相图像，由 10 名盲法判读者进行检查。成像使用海德堡 Spectralis HRA 和 Basler acA2500-14gc GigE 数字视网膜相机进行。使用扫频源光学相干断层扫描作为验证模态。比较了椭圆带破坏、黄斑区椭圆带玫瑰花结、外视网膜折叠、视网膜内囊泡、视网膜下液层、视网膜下液泡泡、视网膜条纹和视网膜脱离线的检出率。评估了模态间和判读者间的一致性。

结果

多色共焦激光扫描检眼镜的整体病理学检测结果明显高于眼底彩色照相（调整后的优势比=7.39；95%置信区间，1.64-33.30；P=0.009）。整体病理学检测的模态间和判读者间一致性为中等。模态间的一致性为 0.49（95%置信区间，0.48-0.51；P<0.0001）（Gwet's AC1）。多色共焦激光扫描检眼镜的判读者间一致性为 0.53（95%置信区间，0.52-0.54；P<0.0001），眼底彩色照相的判读者间一致性为 0.58（95%置信区间，0.57-0.59；P<0.0001）（Fleiss kappa）。