Department of Ophthalmology, Centro Hospitalar Universitário de Lisboa Norte, EPE - Hospital de Santa Maria, Avenida Professor Egas Moniz, 1649-035, Lisbon, Portugal.
Department of Ophthalmology, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.
Int Ophthalmol. 2022 Feb;42(2):455-467. doi: 10.1007/s10792-021-02062-y. Epub 2021 Oct 26.
To evaluate the accuracy of MultiColor imaging (MC) compared to fluorescein angiography (FA) in detecting proliferative diabetic retinopathy (PDR) and associated diabetic retinopathy features.
Fifty-nine eyes from 38 PDR patients were included. MC images were reviewed by 2 independent masked graders. A qualitative analysis based on the following features was performed: neovascular complexes (NVC), disc neovascularization (NVD), neovascularization elsewhere (NVE), microaneurysm (MA), intraretinal hemorrhage (IRH), vitreous hemorrhage (VH), preretinal hemorrhage (PRH), fibrosis, hard exudates (HE), epiretinal membrane (ERM), diabetic macular edema (DME), ischemia and laser spots (LS). Measures of diagnostic accuracy compared to FA were determined.
The sensitivity for the detection of NVC using MC was 95.1%, with a specificity of 40.0%, positive predictive value (PPV) of 92.9% and negative predictive value (NPV) of 50.0%. Sensitivity and specificity were higher in detecting NVD (88.9% and 76.9%) while NVE registered higher PPV (88.9%). MC was highly sensitive in detecting IRH, HE, ERM and LS (100%), MA (98.0%) and fibrosis (95.5%). Highest specificity was found for VH (100.0%), DME (100.0%), PRH (98.1%) and LS (89.5%). The area under the receiver-operating characteristic analysis of MC was excellent in NVD (0.83, 95% confidence interval (CI), 0.71-0.95, p < 0.001), IRH (0.89, 95% CI 0.74-1.00, p < 0.001), VH (0.81, 95% CI 0.60-1.00, p = 0.005) and PRH (0.89, 95% CI 0.68-1.00, p = 0.004) and outstanding in LS detection (0.95, 95% CI 0.87-1.00, p < 0.001). These results are likely due to the contrast and quality of the MC since better discrimination is enabled by the green wavelength.
MC is useful in evaluation of PDR patients and can complement noninvasive imaging. MC detected some PDR features more accurately than FA such as NVD, IRH, VH, PRH, and LS.
评估多光谱成像（MC）在检测增生性糖尿病视网膜病变（PDR）和相关糖尿病视网膜病变特征方面与荧光素血管造影（FA）的准确性。
纳入 38 例 PDR 患者的 59 只眼。由 2 名独立的盲法评分者对 MC 图像进行评估。对以下特征进行定性分析：新生血管复合物（NVC）、视盘新生血管（NVD）、其他部位新生血管（NVE）、微动脉瘤（MA）、视网膜内出血（IRH）、玻璃体积血（VH）、视网膜前出血（PRH）、纤维化、硬性渗出物（HE）、视网膜内膜（ERM）、糖尿病性黄斑水肿（DME）、缺血和激光斑（LS）。比较 FA 后确定 MC 的诊断准确性指标。
使用 MC 检测 NVC 的敏感性为 95.1%，特异性为 40.0%，阳性预测值（PPV）为 92.9%，阴性预测值（NPV）为 50.0%。检测 NVD 的敏感性和特异性更高（88.9%和 76.9%），而 NVE 的 PPV 更高（88.9%）。MC 对 IRH、HE、ERM 和 LS（100%）、MA（98.0%）和纤维化（95.5%）的检测具有高度敏感性。VH（100.0%）、DME（100.0%）、PRH（98.1%）和 LS（89.5%）的特异性最高。MC 在检测 NVD（0.83，95%置信区间（CI），0.71-0.95，p<0.001）、IRH（0.89，95%CI 0.74-1.00，p<0.001）、VH（0.81，95%CI 0.60-1.00，p=0.005）和 PRH（0.89，95%CI 0.68-1.00，p=0.004）方面的受试者工作特征曲线下面积均表现出色，而 LS 检测的面积表现卓越（0.95，95%CI 0.87-1.00，p<0.001）。这些结果可能归因于 MC 的对比度和质量，因为绿色波长可以实现更好的区分。
MC 可用于 PDR 患者的评估，并可补充非侵入性成像。MC 在检测 NVD、IRH、VH、PRH 和 LS 等 PDR 特征方面比 FA 更准确。
