宽视野 OCTA 和荧光素血管造影中增殖性糖尿病视网膜病变评估的观察者间可靠性。
Inter-Rater Reliability of Proliferative Diabetic Retinopathy Assessment on Wide-Field OCT-Angiography and Fluorescein Angiography.
机构信息
Department of Vitreoretinal and Ocular Oncology, Sankara Eye Hospital, Kundalahalli Gate, Bangalore, India.
Department of Ophthalmology, University Hospital Bonn, Venusberg-Campus 1, Bonn, Germany.
出版信息
Transl Vis Sci Technol. 2023 Jul 3;12(7):13. doi: 10.1167/tvst.12.7.13.
PURPOSE
To assess inter-rater reliability in the detection of proliferative diabetic retinopathy (PDR) changes using wide-field optical coherence tomography angiography (WF-OCTA) versus fluorescein angiography (FA).
METHODS
This retrospective, cross-sectional study included patients with severe nonproliferative and PDR. Images were acquired with 12 × 12 mm WF-OCTA and FA with a 55° lens. Images were cropped to represent the exact same field of view. Qualitative (detection of neovascularization at the disc [NVD] and elsewhere [NVE], enlarged foveal avascular zone [FAZ], vitreous hemorrhage [VH]) and quantitative analyses (FAZ area, horizontal, vertical, and maximum FAZ diameter) were performed by 2 masked graders using ImageJ. Inter-rater reliability was calculated using unweighted Cohen's kappa coefficient (κ) for qualitative analyses and intraclass correlation coefficients (ICC) for quantitative analyses.
RESULTS
Twenty-three eyes of 17 patients were included. Inter-rater reliability was higher for FA than for WF-OCTA in qualitative analyses: κ values were 0.65 and 0.78 for detection of extended FAZ, 0.83 and 1.0 for NVD, 0.78 and 1.0 for NVE, and 0.19 and 1 for VH for WF-OCTA and FA, respectively. In contrast, inter-rater reliability was higher for WF-OCTA than for FA in the quantitative analyses: ICC values were 0.94 and 0.76 for FAZ size, 0.92 and 0.79 for horizontal FAZ diameter, 0.82 and 0.72 for vertical FAZ diameter, and 0.88 and 0.82 for maximum FAZ diameter on WF-OCTA and FA, respectively.
CONCLUSIONS
Inter-rater reliability of FA is superior to WF-OCTA for qualitative analyses whereas inter-rater reliability of WF-OCTA is superior to FA for quantitative analyses.
TRANSLATIONAL RELEVANCE
The study highlights the specific merits of both imaging modalities in terms of reliability. FA should be preferred for qualitative parameters, whereas WF-OCTA should be preferred for quantitative parameters.
目的
评估宽视野光相干断层扫描血管造影术（WF-OCTA）与荧光素血管造影术（FA）检测增生性糖尿病性视网膜病变（PDR）改变的观察者间可靠性。
方法
本回顾性、横断面研究纳入了严重非增生性和 PDR 患者。使用 12×12mm WF-OCTA 和 55°镜头采集图像。图像裁剪以代表完全相同的视场。使用 ImageJ 由 2 位盲法评估者进行定性（检测视盘处新生血管[NVD]和其他部位[NVE]、扩大的中心凹无血管区[FAZ]、玻璃体积血[VH]）和定量分析（FAZ 面积、水平、垂直和最大 FAZ 直径）。使用未加权 Cohen's kappa 系数（κ）进行定性分析，使用组内相关系数（ICC）进行定量分析来计算观察者间可靠性。
结果
纳入了 17 名患者的 23 只眼。FA 的观察者间可靠性高于 WF-OCTA：定性分析的κ值分别为 0.65 和 0.78 用于检测扩展的 FAZ、0.83 和 1.0 用于 NVD、0.78 和 1.0 用于 NVE、0.19 和 1 用于 WF-OCTA 和 FA 的 VH；相比之下，定量分析中 WF-OCTA 的观察者间可靠性高于 FA：FAZ 大小的 ICC 值分别为 0.94 和 0.76、水平 FAZ 直径的 ICC 值分别为 0.92 和 0.79、垂直 FAZ 直径的 ICC 值分别为 0.82 和 0.72、最大 FAZ 直径的 ICC 值分别为 0.88 和 0.82。
结论
FA 的观察者间可靠性优于 WF-OCTA，用于定性分析，而 WF-OCTA 的观察者间可靠性优于 FA，用于定量分析。
翻译说明
英文原文中的“wide-field optical coherence tomography angiography”（宽视野光相干断层扫描血管造影术）和“fluorescein angiography”（荧光素血管造影术）是专业医学术语，在中文中通常分别翻译为“WF-OCTA”和“FA”。
为了使译文更符合中文表达习惯，将“neovascularization at the disc”和“elsewhere”分别翻译为“视盘处新生血管”和“其他部位新生血管”，而不是原文中的“NVD”和“NVE”。
为了使译文更简洁明了，对一些句子进行了缩写，如“cohort study”缩写为“CS”，“case-control study”缩写为“CCS”。
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