Casagrande Maria, Steinhorst Nils Alexander, Dippel Susanne Kathrin, Kück Fabian, Grohmann Carsten, Spitzer Martin S, Poli Sven, Feltgen Nicolas, Schultheiss Maximilian
Department of Ophthalmology, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany.
Department of Ophthalmology, University Medical Center Göttingen, Göttingen, Germany.
Front Med (Lausanne). 2023 Mar 1;10:1129002. doi: 10.3389/fmed.2023.1129002. eCollection 2023.
To investigate the sensitivity and specificity of central retinal artery occlusion (CRAO)-Detection Score in diagnosing CRAO questionnaire and without fundoscopy.
This prospective study enrolled 176 emergency patients suffering from acute visual loss, of whom 38 were suffering from CRAO. Before conducting any examination, we administered our questionnaire containing six questions, followed by a thorough ophthalmologic examination to make the diagnosis. Statistical analysis involved a LASSO penalised multivariate logistic regression model.
Our receiver operating characteristic (ROC) analysis based on a LASSO penalised multivariate logistic regression model showed an area under the curve (AUC) of 0.9 - three out of six questions were selected by LASSO. Interestingly, the unweighted ROC analysis of only two questions (Short CRAO-Detection Score) yielded similar results with an AUC of 0.88. The short CRAO-Detection Score of 2 yielded 14% (4/28) false positive patients.
This prospective study demonstrates that a high percentage of CRAO patients are detectable with a questionnaire. The CRAO-Detection Score might be used to triage patients suffering acute visual loss, which is important as intravenous fibrinolysis seem to be time-dependent to be effective.
探讨视网膜中央动脉阻塞（CRAO）检测评分在不进行眼底镜检查情况下诊断CRAO问卷的敏感性和特异性。
这项前瞻性研究纳入了176例急性视力丧失的急诊患者，其中38例患有CRAO。在进行任何检查之前，我们发放了包含六个问题的问卷，随后进行全面的眼科检查以做出诊断。统计分析采用LASSO惩罚多元逻辑回归模型。
基于LASSO惩罚多元逻辑回归模型的受试者工作特征（ROC）分析显示曲线下面积（AUC）为0.9 - LASSO选择了六个问题中的三个。有趣的是，仅对两个问题进行的非加权ROC分析（简短CRAO检测评分）得出了相似的结果，AUC为0.88。简短CRAO检测评分为2时，有14%（4/28）的患者出现假阳性。
这项前瞻性研究表明，通过问卷可以检测出高比例的CRAO患者。CRAO检测评分可用于对急性视力丧失患者进行分诊，这很重要，因为静脉溶栓似乎对时间有依赖性才能有效。
