Classifying the severity of corneal ulcers by using the "1, 2, 3" rule.
Classifying the severity of corneal ulcers by using the "1, 2, 3" rule.
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使用“1、2、3”规则对角膜溃疡的严重程度进行分类。
DOI：
10.1097/ico.0b013e31802b2e47
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发表时间：
2007
期刊：
影响因子：
2.8
通讯作者：
Lanier,JeffreyD
中科院分区：
文献类型：
--
作者：
Vital,MarkC;Belloso,Marcel;Prager,ThomasC;Lanier,JeffreyD
目的：提出和定义“1，2，3”规则作为细菌性角膜炎严重程度的分类系统，并确定其在预测细菌性角膜感染愈合后视力丧失的可能性中的价值。方法：2001年10月30日至2004年11月1日，在三级医院由2名角膜专科医生(JDL，MCV)对70例患者进行感染性角膜溃疡评估。41名患者符合纳入标准。结果：“1，2，3”规则检测潜在威胁视力(PST)溃疡的敏感度为100%，如果PST溃疡导致0.20logMAR(2条Snellen线)或最佳矫正视力(BSCVA)损失更大。“1，2，3”规则正确地将未导致视力丧失的溃疡标记为罕见视力威胁(RST)的特异度为57.14%。“1，2，3”规则的阳性预测值为28.57%。“1，2，3”规则的阴性预测值为100%。结论：与RST角膜溃疡相比，PST角膜溃疡持续丧失BCSVA的风险显著增加。“1，2，3”规则足够敏感和具体，在临床上可以用来预测哪些溃疡更有可能出现视力丧失，哪些没有。
Purpose:To propose and define the “1, 2, 3” rule as a system of categorizing the severity of bacterial keratitis and to determine its value in predicting the likelihood of visual loss after healing of bacterial corneal infection.Methods:Seventy patients were evaluated for infectious corneal ulcers by 2 cornea subspecialists (JDL, MCV) at a tertiary facility between October 30, 2001, and November 1, 2004. Forty-one patients met the inclusion criteria. Visual acuities, ulcer characteristics, culture results, and treatment data were collected.Results:The sensitivity of the “1, 2, 3” rule for detecting potentially sight-threatening (PST) ulcers that would result in 0.20 logMAR (2 Snellen lines) or greater loss in best spectacle-corrected visual acuity (BSCVA) was 100%. The specificity of the “1, 2, 3” rule in correctly labeling an ulcer that did not cause vision loss as rarely sight threatening (RST) was 57.14%. The positive predictive value of the “1, 2, 3” rule was 28.57%. The negative predictive value of the “1, 2, 3” rule was 100%.Conclusions:Corneal ulcers classified as PST are at significantly higher risk for sustaining loss of BCSVA compared with RST corneal ulcers. The “1, 2, 3” rule is sensitive and specific enough to be clinically useful in predicting which ulcers are more likely to have vision loss and which ulcers are not.