Coleman A L, Sommer A, Enger C, Knopf H L, Stamper R L, Minckler D S
Jules Stein Eye Institute, UCLA School of Medicine 90095-7004, USA.
J Glaucoma. 1996 Dec;5(6):384-9.
To evaluate the potential value of obtaining follow-up stereoscopic photographs on glaucoma suspects in identifying progressive optic nerve damage.
Nineteen sets of stereoscopic optic disc photographs, reflecting one eye from each of 19 patients at two time points, were selected from the records of subjects enrolled in the Glaucoma Screening Study. By consensus, three experts judged 13 of these eyes to have progressive glaucomatous optic nerve damage. Four other ophthalmologists who were masked to the expert panel evaluation then assessed glaucomatous progression in the same eyes. They were asked to evaluate glaucomatous progression in three ways: first, by drawing the optic nerve head appearance from initial stereoscopic photographs and later comparing their own drawings to follow-up stereoscopic photographs; second, by comparing serial stereoscopic photographs directly; and third, by comparing drawings of the optic nerve head made by another examiner to the follow-up photographs.
Neither sensitivity nor specificity was consistently better for serial stereoscopic photographs than for drawings. Individual ophthalmologist agreement rates with the expert panel's determinations of progression were 23-62% when examiners compared their own drawings to follow-up photographs, 54-71% when examiners compared serial stereoscopic photographs, and 38-85% when comparing another ophthalmologist's drawings to follow-up photographs.
Baseline stereoscopic photographs of the optic nerve head did not substantially improve recognition of progressive glaucomatous optic nerve damage when compared with the use of baseline drawings of the optic nerve head made from photographs in subjects who developed visual loss in the interim.
评估对青光眼可疑患者进行随访立体照片拍摄在识别进行性视神经损伤方面的潜在价值。
从青光眼筛查研究受试者的记录中选取了19组立体视盘照片，反映了19名患者在两个时间点各一只眼睛的情况。经三位专家一致判断，其中13只眼睛存在进行性青光眼性视神经损伤。另外四位对专家小组评估不知情的眼科医生随后对同一批眼睛的青光眼进展情况进行了评估。他们被要求通过三种方式评估青光眼进展情况：第一，根据初始立体照片绘制视神经乳头外观，随后将自己绘制的图与随访立体照片进行比较；第二，直接比较系列立体照片；第三，将另一位检查者绘制的视神经乳头图与随访照片进行比较。
系列立体照片的敏感性和特异性并不始终优于绘图。当检查者将自己绘制的图与随访照片进行比较时，个体眼科医生与专家小组对进展情况判定的一致率为23% - 62%；当检查者比较系列立体照片时，一致率为54% - 71%；当将另一位眼科医生绘制的图与随访照片进行比较时，一致率为38% - 85%。
与使用在随访期间出现视力丧失的受试者照片绘制的视神经乳头基线图相比，视神经乳头的基线立体照片在识别进行性青光眼性视神经损伤方面并没有显著改善。
