Park Su Hwan, Chey Ji Hyoung, Heo Jun, Han Kwang Eon, Park Sung Who, Byon Iksoo, Kwon Han Jo
Department of Ophthalmology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan-si, Gyeongsangnam-do, South Korea.
Department of Ophthalmology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea.
PLoS One. 2024 Dec 5;19(12):e0306091. doi: 10.1371/journal.pone.0306091. eCollection 2024.
To compare the diagnostic capacity of a color fundus camera (CFC), ultra-wide-field bicolor confocal scanning laser ophthalmoscope (BC-cSLO; OPTOS), and true-color confocal scanning ophthalmoscope (TC-cSO; EIDON) in detecting coexisting retinal diseases in eyes with asteroid hyalosis (AH).
The medical records of consecutive patients with AH who were referred to a tertiary hospital for subsequent assessment by a vitreoretinal specialist were retrospectively reviewed. Fundus images obtained simultaneously using CFC, BC-cSLO, and TC-cSO were classified into four grades based on their obscuration by asteroid bodies. The proportion of Grade 1 images (minimal obscuration group) was assessed for each imaging modality. The diagnostic and screening abilities for concurrent retinal diseases were compared in terms of the accuracy and sensitivity of each device.
Among the 100 eyes with AH, 76 had coexisting retinal diseases, such as diabetic retinopathy (DR), retinal vascular occlusion, age-related macular degeneration, epiretinal membrane, and retinitis pigmentosa. TC-cSO had the highest ratio of Grade 1 images (94%, P<0.001), followed by CFC (67%) and BC-cSLO (63%). CFC and BC-cSLO exhibited a 5.3-fold higher rate of significant obscuration than TC-cSO (P<0.001, 95% confidence intervals = 2.4~11.6 folds). TC-cSO demonstrated the highest accuracy and sensitivity (95% and 81%, respectively) compared with CFC (89% and 43%, respectively) and BC-cSLO (89% and 39%, respectively) for all retinal diseases. BC-cSLO showed the best performance for DR diagnosis.
TC-cSO images showed minimal obscuration and a superior ability for diagnosing retinal diseases accompanied by AH over other imaging devices. TC-cSO can be a valuable alternative screening tool for detecting retinal diseases when AH impedes fundus imaging.
比较彩色眼底照相机（CFC）、超广角双色共焦扫描激光检眼镜（BC-cSLO；OPTOS）和真彩色共焦扫描检眼镜（TC-cSO；EIDON）在检测伴有星状玻璃体病变（AH）的眼睛中并存视网膜疾病的诊断能力。
回顾性分析连续就诊于一家三级医院并由玻璃体视网膜专科医生进行后续评估的AH患者的病历。使用CFC、BC-cSLO和TC-cSO同时获取的眼底图像根据星状体的遮挡程度分为四个等级。评估每种成像方式下1级图像（最小遮挡组）的比例。从每种设备的准确性和敏感性方面比较对并存视网膜疾病的诊断和筛查能力。
在100只患有AH的眼中，76只并存有视网膜疾病，如糖尿病性视网膜病变（DR）、视网膜血管阻塞、年龄相关性黄斑变性、视网膜前膜和色素性视网膜炎。TC-cSO的1级图像比例最高（94%，P<0.001），其次是CFC（67%）和BC-cSLO（63%）。CFC和BC-cSLO的显著遮挡率比TC-cSO高5.3倍（P<0.001，95%置信区间=2.4至11.6倍）。对于所有视网膜疾病，与CFC（分别为89%和43%）和BC-cSLO（分别为89%和39%）相比，TC-cSO表现出最高的准确性和敏感性（分别为95%和81%）。BC-cSLO在DR诊断方面表现最佳。
与其他成像设备相比，TC-cSO图像的遮挡最小，在诊断伴有AH的视网膜疾病方面具有卓越能力。当AH妨碍眼底成像时，TC-cSO可作为检测视网膜疾病的有价值的替代筛查工具。
