Heijl A, Mölder H
Department of Ophthalmology, University of Lund, Malmö, Sweden.
Acta Ophthalmol (Copenh). 1993 Feb;71(1):122-9. doi: 10.1111/j.1755-3768.1993.tb04974.x.
We studied the influence of optic disc diameter on the diagnostic power of subjective disc evaluation of glaucoma. One hundred and thirteen colour disc photographs of 91 patients with primary open angle glaucoma and 174 photographs of 89 randomly selected normal subjects were studied. Five ophthalmologists independently classified all eyes as glaucomatous or normal by disc appearance using a masked forced choice design. Sensitivities and specificities varied strongly as a function of disc diameter. Overall sensitivity for recognizing glaucoma by disc inspection was 58% in small discs, 72% in the middle group and 85% in the group of large discs. These differences were significant, and the odds of recognizing a glaucomatous disc as such increased by a factor of 2.07 between each group. Overall specificity was 99.6% in small discs, 95% in the middle group, and 79% in large normal discs. Thus, larger discs were more likely to be classified as glaucomatous whether they were glaucomatous or not, while small discs were more likely to be classified as normal.
我们研究了视盘直径对青光眼主观视盘评估诊断效能的影响。研究了91例原发性开角型青光眼患者的113张彩色视盘照片以及89名随机选取的正常受试者的174张照片。五位眼科医生采用隐蔽强制选择设计，根据视盘外观将所有眼睛独立分类为青光眼性或正常。敏感性和特异性随视盘直径变化很大。通过视盘检查识别青光眼的总体敏感性在小视盘中为58%，在中等视盘组中为72%，在大视盘组中为85%。这些差异具有显著性，每组之间将青光眼性视盘识别为青光眼的几率增加了2.07倍。小视盘的总体特异性为99.6%，中等视盘组为95%，大正常视盘中为79%。因此，无论是否为青光眼性，较大的视盘更有可能被分类为青光眼性，而较小的视盘更有可能被分类为正常。
