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光学相干断层扫描结合眼底照相在高度近视患者视网膜病变筛查中的价值。

Value of Combining Optical Coherence Tomography with Fundus Photography in Screening Retinopathy in Patients with High Myopia.

机构信息

Department of Ophthalmology, Nanjing Tongren Hospital, School of Medicine, Southeast University, Nanjing 211102, Jiangsu Province, China.

Department of Ophthalmology, Central Hospital Affiliated to Shandong First Medical University, Jinan, 250013, Shandong Province, China.

出版信息

J Healthc Eng. 2022 Apr 11;2022:6556867. doi: 10.1155/2022/6556867. eCollection 2022.

Abstract

OBJECTIVE

To explore the value of combining optical coherence tomography (OCT) with fundus photography in screening retinopathy in patients with high myopia.

METHODS

By means of retrospective study, 40 high myopia patients with retinopathy treated in our hospital from January 2020 to January 2021 were selected as the study group, and 40 healthy individuals in the same period were included in the control group. All patients received traditional ophthalmic examination, and accepted fundus fluorescence imaging, OCT, and fundus photography examination step by step by the same operator. After that, three physicians read the slides by the double blind method, and took the results of fundus fluorescence imaging as the gold standard to analyze the diagnostic efficacy of OCT, fundus photography and their combination.

RESULTS

The clinical data and examination results showed that no statistical differences in general data including patients' mean age, gender ratio, and educational degree between the study group and the control group were observed ( > 0.05), and the nerve thickness above/below the optic disk and temporal/nasal nerve thickness of the optic disk of the study group were significantly different from those of the control group ( < 0.001); the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy rate of diagnosis of combining OCT with fundus photography were respectively 95.0%, 97.5%, 97.4%, 95.1%, and 96.3%, which were significantly higher than OCT or fundus photography alone ( < 0.05); and for combined examination, AUC (95%CI) = 0.963 (0.000-1.000).

CONCLUSION

Combining OCT with fundus photography can effectively identify high myopia patients with retinopathy, which is conducive to improving clinical positive ratio and providing objective basis for treatment.

摘要

目的

探讨光学相干断层扫描(OCT)结合眼底照相在筛查高度近视患者视网膜病变中的价值。

方法

采用回顾性研究方法,选取 2020 年 1 月至 2021 年 1 月在我院治疗的 40 例高度近视合并视网膜病变患者作为观察组,同时选取同期在我院体检的 40 例健康者作为对照组。所有患者均接受传统眼科检查,并由同一位操作者依次接受眼底荧光造影、OCT、眼底照相检查。然后由 3 位医师采用双盲法阅片,以眼底荧光造影结果为金标准,分析 OCT、眼底照相及其联合检查的诊断效能。

结果

临床资料及检查结果显示,观察组与对照组患者的一般资料(年龄、性别比、受教育程度)比较差异均无统计学意义( > 0.05),且观察组患者视盘上方/下方神经厚度和视盘颞侧/鼻侧神经厚度均明显低于对照组( < 0.001);OCT 结合眼底照相检查的诊断灵敏度、特异度、阳性预测值(PPV)、阴性预测值(NPV)、准确率分别为 95.0%、97.5%、97.4%、95.1%、96.3%,均明显高于 OCT 或眼底照相单独检查( < 0.05);且联合检查的曲线下面积(AUC)(95%CI)为 0.963(0.000~1.000)。

结论

OCT 结合眼底照相能够有效识别高度近视合并视网膜病变患者,有助于提高临床阳性检出率,为治疗提供客观依据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/451b/9017439/37347adf0e23/JHE2022-6556867.001.jpg

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