Karatepe Hashas Arzu Seyhan, Popovic Zoran, Abu-Ishkheidem Emad, Bond-Taylor Martin, Svedberg Karin, Jarar Dana, Zetterberg Madeleine
Department of Ophthalmology, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden.
Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Acta Ophthalmol. 2023 Sep;101(6):627-635. doi: 10.1111/aos.15652. Epub 2023 Mar 6.
This study was performed with the aim of finding a more convenient and less time-consuming method to diagnose retinal breaks in posterior vitreous detachment (PVD) patients.
A prospective double-blind observational case study was performed with patients who were admitted to the Eye Emergency Department Sahlgrenska University Hospital with PVD symptoms and approved to participate in the study (n = 128). Standard slit lamp examination was compared with images from a Zeiss Clarus 700 ultra-wide-field camera (UWFC). Patients were examined and photographed by an independent operator. Data and image review was performed by three independent reviewers with varying experience. Retinal break detection with the two different methods (detailed eye examination by well-trained ophthalmologist and UWFC evaluations) was analysed statistically.
After excluding diagnoses other than PVD as well as unclear images due to cataracts, vitreous bleeding, etc., a total of 103 eyes with PVD were evaluated. A total of 38 ruptures in 25 patients were detected by routine examination and were subjected to laser treatment. UWFC images were reviewed by three ophthalmology consultants and compared with routine examinations. Sensitivity values in detecting retinal ruptures in UWFC images of the three reviewers were 0.89, 0.87 and 0.79, and specificity values were 0.88, 0.86 and 0.93 (kappa values: 0.742, 0.689 and 0.728) respectively.
Although there have been rapid developments in imaging with UWFC in recent years and it is a very promising method for the future, routine clinical examination is still the only valid method for the detection of retinal tears today.
本研究旨在寻找一种更便捷、耗时更少的方法来诊断玻璃体后脱离（PVD）患者的视网膜裂孔。
对因PVD症状入住萨尔格伦斯卡大学医院眼科急诊科且被批准参与研究的患者进行了一项前瞻性双盲观察性病例研究（n = 128）。将标准裂隙灯检查与蔡司Clarus 700超广角相机（UWFC）拍摄的图像进行比较。由一名独立操作人员对患者进行检查和拍照。由三名经验各异的独立评审员进行数据和图像审查。对两种不同方法（由训练有素的眼科医生进行详细眼部检查和UWFC评估）检测视网膜裂孔的情况进行统计学分析。
排除PVD以外的诊断以及因白内障、玻璃体出血等导致的图像不清晰情况后，共评估了103只患有PVD的眼睛。通过常规检查在25名患者中总共检测到38处裂孔，并对其进行了激光治疗。三名眼科顾问对UWFC图像进行了审查，并与常规检查进行了比较。三名评审员在UWFC图像中检测视网膜裂孔的敏感度值分别为0.89、0.87和0.79，特异度值分别为0.88、0.86和0.93（kappa值：0.742、0.689和0.728）。
尽管近年来UWFC成像技术发展迅速，且对未来而言是一种非常有前景的方法，但常规临床检查仍是目前检测视网膜裂孔的唯一有效方法。
