Validity of screening for glaucomatous optic nerve damage using confocal scanning laser ophthalmoscopy (Heidelberg Retina Tomograph II) in high-risk populations: a pilot study.
Validity of screening for glaucomatous optic nerve damage using confocal scanning laser ophthalmoscopy (Heidelberg Retina Tomograph II) in high-risk populations: a pilot study.
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使用共焦扫描激光检眼镜（海德堡视网膜断层扫描 II）在高危人群中筛查青光眼视神经损伤的有效性：一项试点研究。
DOI：
10.1016/j.ophtha.2005.09.009
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发表时间：
2005
期刊：
影响因子：
13.7
通讯作者：
M. Lesk
中科院分区：
文献类型：
--
作者：
P. Harasymowycz;D. Papamatheakis;A. K. Fansi;J. Gresset;M. Lesk
目的评价共焦扫描激光眼底镜(Heidelberg Retina Tomograph II[HRT II]，Heidelberg Engineering，Heidelberg，德国)是否是检测青光眼视神经损伤的有效工具。设计在加拿大蒙特利尔进行的一项观察性、横断面、非连续研究，在6个月期间纳入300名非连续的高危人群。方法受试者接受HRT II测试和标准眼科检查，包括房角镜、眼压测量和视盘分级。MAIN结果衡量ESR阳性似然比(PLR)和阴性似然比(NLR)，敏感性和特异性，阳性预测值(PPV)和阴性预测值(NPV)，Moorfield回归分析、视杯形状测量、身高变异等值线和平均视网膜神经纤维层厚度的κ一致性系数。合并青光眼21例(7.2%)。海德堡视网膜断层扫描仪II测试成功，601只眼中有531只眼(88%)质量可接受。与临床诊断比较，右眼加权κ系数κ=0.567(95%可信区间0.42~0.71)，左眼κ=0.516(95%可信区间0.37~0.66)。当正常人与临床和磁共振血管成像诊断可疑患者分组时，κ一致性系数最好(κ=0.604；95%CI，右眼为0.409~0.799)。根据青光眼的金标准和阳性定义，特异度从87%到97%，敏感度从25%到100%，PPV从28%到68%，NPV从84%到100%，PLR从5.0到19.2，NLR从1.3到6.2。当CSM、HVC和MRNFLT与临床诊断进行比较时，所有结果指标的特异度从46.9%到83.7%，灵敏度从36.5%到76.9%，PPV从6%到36%，NPV从80%到99%，PLR从0.8到4.0，NLR从0.9到3.0。结论本研究结果表明，青光眼筛查程序可能在针对高危人群时有效地检测青光眼。海德堡视网膜断层扫描仪II测试可能被证明是检测青光眼视神经损伤的有用工具，并可作为完整青光眼筛查方案的一部分。
PURPOSETo evaluate whether confocal scanning laser ophthalmoscopy (Heidelberg Retina Tomograph II [HRT II], Heidelberg Engineering, Heidelberg, Germany) is a valid tool for the detection of glaucomatous optic nerve damage.DESIGNObservational, cross-sectional, nonconsecutive study in Montreal, Canada.PARTICIPANTSThree hundred three nonconsecutive, high-risk persons were enrolled during a 6-month period.METHODSParticipants underwent HRT II testing and a standard ophthalmologic examination, including gonioscopy, intraocular pressure measurement, and optic disc grading.MAIN OUTCOME MEASURESPositive likelihood ratio (PLR) and negative likelihood ratio (NLR), sensitivities and specificities, positive predictive value (PPV) and negative predictive value (NPV), and κ coefficients of agreement of Moorfields regression analysis (MRA), cup shape measure (CSM), height variation contour (HVC), and mean retinal nerve fiber layer thickness (MRNFL).RESULTSThree hundred three participants were enrolled, and 291 were examined clinically; 21 (7.2%) were found to have glaucoma. Heidelberg Retina Tomograph II testing was performed successfully and was of acceptable quality in 531 of 601 eyes (88%). When MRA was compared with the clinically based diagnosis, the weighted κ coefficient was κ = 0.567 (95% confidence interval [CI], 0.42–0.71) for the right eye and κ = 0.516 (95% CI, 0.37–0.66) for the left eye. Best κ coefficient of agreement was seen when normals were grouped with suspects in both clinical and MRA diagnosis (κ = 0.604; 95% CI, 0.409–0.799 in the right eye). Depending on the gold standard and test-positive definitions for glaucoma, specificity ranged from 87% to 97%, sensitivity from 25% to 100%, PPV from 28% to 68%, NPV from 84% to 100%, PLR from 5.0 to 19.2, and NLR from 1.3 to 6.2. When CSM, HVC, and MRNFLT were compared with clinical diagnosis, all outcome measures were found to have lower ranges: specificity from 46.9% to 83.7%, sensitivity from 36.5% to 76.9%, PPV from 6% to 36%, NPV from 80% to 99%, PLR from 0.8 to 4.0, NLR from 0.9 to 3.0.CONCLUSIONSThe results of this study suggest that a glaucoma screening program may be effective in detecting glaucoma when targeting high-risk populations. Heidelberg Retina Tomograph II testing may prove to be a useful tool in detecting glaucomatous optic nerve damage and could be used as part of a complete glaucoma screening protocol.
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影响因子：
158.5
作者：
SOMMER, A;TIELSCH, JM;EZRINE, S
通讯作者：
EZRINE, S
影响因子：
--
作者：
SOMMER, A;TIELSCH, JM;SINGH, K
通讯作者：
SINGH, K
青光眼中视乳头周围神经纤维层表面的斜率。
DOI：
--
发表时间：
1998
期刊：
Investigative ophthalmology & visual science.
影响因子：
--
作者：
Caprioli,J;Park,HJ;Ugurlu,S;Hoffman,D
通讯作者：
Hoffman,D
用共焦扫描激光断层扫描检测早期青光眼结构损伤。
影响因子：
2
作者：
Bathija,R;Zangwill,L;Berry,CC;Sample,PA;Weinreb,RN
通讯作者：
Weinreb,RN
使用视神经乳头分析仪进行地形测量的准确性。
影响因子：
4.2
作者：
Shields,MB;Tiedeman,JS;Miller,KN;Hickingbotham,D;Ollie,AR
通讯作者：
Ollie,AR