超广角眼底摄影与巩膜压迫检查对视网膜马蹄形裂孔检测的敏感性比较

The Sensitivity of Ultra-Widefield Fundus Photography Versus Scleral Depressed Examination for Detection of Retinal Horseshoe Tears.

作者信息

Lin Andrew C, Kalaw Fritz Gerald P, Schönbach Etienne M, Song Delu, Koretz Zachary, Walker Evan, Breazzano Mark P, Scott Nathan L, Borooah Shyamanga, Ferreyra Henry, Spencer Doran B, Goldbaum Michael H, Nudleman Eric D, Freeman William R, Toomey Christopher B

机构信息

From the Shiley Eye Institute (A.C.L., F.G.P.K., E.M.S., D.S., Z.K., E.W., N.L.S., S.B., H.F., D.B.S., M.H.G., E.D.N., W.R.F., C.B.T.), Viterbi Family Department of Ophthalmology at University of California, San Diego, La Jolla, California, USA; Division of Ophthalmology Informatics and Data Science (F.G.P.K.), Viterbi Family Department of Ophthalmology at University of California, San Diego, La Jolla, California, USA.

出版信息

Am J Ophthalmol. 2023 Nov;255:155-160. doi: 10.1016/j.ajo.2023.07.010. Epub 2023 Jul 17.

DOI:10.1016/j.ajo.2023.07.010

PMID:37468086

Abstract

PURPOSE

Ultra-widefield (UWF) imaging is commonly used in ophthalmology in tandem with scleral depressed examinations (SDE) to evaluate peripheral retinal disease. Because of the increased reliance on this technology in tele-ophthalmology, it is critical to evaluate its efficacy for detecting the peripheral retina when performed in isolation. Therefore, we sought to evaluate UWF imaging sensitivity in detecting retinal horseshoe tears (HSTs).

STUDY DESIGN

Retrospective clinical validity and reliability study.

METHODS

A single-institutional retrospective analysis was performed on patients at the Shiley Eye Institute, University of California, San Diego. Patients with HSTs seen on SDE who underwent treatment with laser were included in the study. A total of 140 patients with HSTs in the right and/or left eyes met the inclusion criteria. Those with concomitant ruptured globes, retinal detachments, and vitreous hemorrhages were excluded. A total of 123 patients with 135 HSTs were included in the final analysis. The primary outcome was the number of HSTs detected by UWF imaging. A secondary outcome was HST location. Sensitivity was measured with respect to HST location, and statistical significance was calculated by Fisher exact testing.

RESULTS

A total of 69 (51.1%) HSTs were visualized on UWF images and 66 (48.9%) were not visualized. The sensitivity of UWF imaging in capturing HSTs was 7 of 41 (17.1%), 8 of 25 (32.0%), 7 of 14 (50.0%), and 47 of 55 (85.5%) for the superior, inferior, nasal, and temporal quadrants, respectively. Sensitivities between HST visibility and location were statistically significant (P < .001).

CONCLUSIONS

Nearly half of HSTs were missed by UWF imaging. This study demonstrates that UWF imaging alone is not sufficiently sensitive to exclude the presence of HSTs.

摘要

目的

超广角（UWF）成像在眼科中通常与巩膜压迫检查（SDE）联合使用，以评估周边视网膜疾病。由于在远程眼科中对该技术的依赖增加，因此在单独进行时评估其检测周边视网膜的功效至关重要。因此，我们试图评估UWF成像检测视网膜马蹄形裂孔（HST）的敏感性。

研究设计

回顾性临床有效性和可靠性研究。

方法

对加利福尼亚大学圣地亚哥分校希利眼科研究所的患者进行单机构回顾性分析。纳入在SDE上发现有HST并接受激光治疗的患者。共有140例右眼和/或左眼患有HST的患者符合纳入标准。排除伴有眼球破裂、视网膜脱离和玻璃体积血的患者。最终分析纳入了123例患者的135个HST。主要结局是通过UWF成像检测到的HST数量。次要结局是HST的位置。根据HST位置测量敏感性，并通过Fisher精确检验计算统计学意义。

结果

在UWF图像上共观察到69个（51.1%）HST，66个（48.9%）未观察到。UWF成像捕捉HST的敏感性在上方象限为41个中的7个（17.1%），下方象限为25个中的8个（32.0%），鼻侧象限为14个中的7个（50.0%），颞侧象限为55个中的47个（85.5%）。HST可见性与位置之间的敏感性具有统计学意义（P <.001）。