Anton Alfonso, Nolivos Karen, Pazos Marta, Fatti Gianluca, Ayala Miriam Eleonora, Martínez-Prats Elena, Peral Oscar, Poposki Vladimir, Tsiroukis Evangelos, Morilla-Grasa Antonio, Comas Merce, Castells Xavier
Research Department, Institut Català de la Retina (ICR), 08017 Barcelona, Spain.
Medical School, Universitat Internacional de Catalunya, 08017 Barcelona, Spain.
J Clin Med. 2021 Dec 31;11(1):216. doi: 10.3390/jcm11010216.
The aim of this study was to evaluate the diagnostic accuracy of optical coherence tomography (OCT) and retinography in the detection of glaucoma through a telemedicine program.
A population-based sample of 4113 persons was randomly selected. The screening examination included a fundus photograph and OCT images. Images were evaluated on a deferred basis. All participants were then invited to a complete glaucoma examination, including gonioscopy, visual field, and dilated fundus examination. The detection rate, sensitivity, specificity, and positive and negative predictive values were calculated.
We screened 1006 persons. Of these, 201 (19.9%) were classified as glaucoma suspects; 20.4% were identified only by retinographs, 11.9% only by OCT images, and 46.3% by both. On ophthalmic examination at the hospital ( = 481), confirmed glaucoma was found in 58 (12.1%), probable glaucoma in 76 (15.8%), and ocular hypertension in 10 (2.1%), and no evidence of glaucoma was found in 337 (70.0%). The detection rate for confirmed or probable glaucoma was 9.2%. Sensitivity ranged from 69.4% to 86.2% and specificity from 82.1% to 97.4%, depending on the definition applied.
The combination of OCT images and fundus photographs yielded a detection rate of 9.2% in a population-based screening program with moderate sensitivity, high specificity, and predictive values of 84-96%.
本研究旨在通过远程医疗项目评估光学相干断层扫描（OCT）和视网膜成像在青光眼检测中的诊断准确性。
随机选取了4113人的基于人群的样本。筛查检查包括眼底照片和OCT图像。图像在延迟基础上进行评估。然后邀请所有参与者进行全面的青光眼检查，包括前房角镜检查、视野检查和散瞳眼底检查。计算检测率、敏感性、特异性以及阳性和阴性预测值。
我们筛查了1006人。其中，201人（19.9%）被归类为青光眼疑似患者；仅通过视网膜成像识别出20.4%，仅通过OCT图像识别出11.9%，两者均识别出46.3%。在医院进行眼科检查（n = 481）时，确诊青光眼的有58人（12.1%），疑似青光眼的有76人（15.8%），高眼压的有10人（2.1%），337人（70.0%）未发现青光眼迹象。确诊或疑似青光眼的检测率为9.2%。根据所应用的定义，敏感性范围为69.4%至86.2%，特异性范围为82.1%至97.4%。
在基于人群的筛查项目中，OCT图像和眼底照片相结合的检测率为9.2%，具有中等敏感性、高特异性以及84 - 96%的预测值。
