Technology and the Glaucoma Suspect.
Technology and the Glaucoma Suspect.
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技术和青光眼嫌疑人。
DOI：
10.1167/iovs.15-18931
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发表时间：
2016-07-01
影响因子：
4.4
通讯作者：
Hood DC
中科院分区：
文献类型：
--
作者：
Blumberg DM;De Moraes CG;Liebmann JM;Garg R;Chen C;Theventhiran A;Hood DC
确定并比较光谱域光学相干断层扫描（SD-OCT）、立体视盘照片和自动视野检查在区分早期青光眼患者和可疑患者方面的诊断性能，这些诊断性能由一组青光眼专家评估。46只眼（46例患者）可疑视神经先前接受了SD-OCT扫描、24-2视野（VF）和视盘照片。平均VF平均偏差为−1.97 ± 2.09（SD）dB。四位青光眼专家检查了138项单独的诊断测试，并根据一项测试的结果将患者分为可能的青光眼或非青光眼。将三种测试中每一种的诊断性能与先前确定的参考标准进行比较，该参考标准是基于一个单独的小组的共识，该小组由四名青光眼专家组成，他们一起检查了所有三种测试。在四位专家中，VF和照片的三种诊断测试的观察者间一致性较差，kappa（κ）值分别为0.13和0.16，OCT为中度，κ值为0.40。使用专家组共识作为参考标准，OCT具有最高的辨别能力，曲线下面积（AUC）为0.99（95% 0.96-1.0），而照片AUC为0.85（95% 0.73-0.96），VF AUC为0.86（95% 0.76-0.96），表明其性能更接近青光眼专家组的性能。与VF和椎间盘摄影相比，单独使用SD-OCT时，其内部一致性更好，并且与使用所有可用数据的临床医生共识的一致性更好。未来的研究应评价SD-OCT解释的最佳实践。
To determine and compare the diagnostic performance of spectral-domain optical coherence tomography (SD-OCT), stereoscopic disc photographs, and automated perimetry as assessed by a group of glaucoma specialists in differentiating individuals with early glaucoma from suspects. Forty-six eyes (46 patients) with suspicious optic nerves had previously undergone SD-OCT scans, 24-2 visual fields (VFs), and optic disc photographs. The average VF mean deviation was −1.97 ± 2.09 (SD) dB. Four glaucoma specialists examined the 138 individual diagnostic tests and classified the patient as likely glaucomatous or nonglaucomatous based on the results of a single test. The diagnostic performances of each of the three tests were compared to a previously determined reference standard, based on the consensus of a separate panel of four glaucoma specialists who examined all three tests together. Among the four specialists, the interobserver agreement across the three diagnostic tests was poor for VF and photos, with kappa (κ) values of 0.13 and 0.16, respectively, and moderate for OCT, with κ value of 0.40. Using panel consensus as reference standard, OCT had the highest discriminative ability, with an area under the curve (AUC) of 0.99 (95% 0.96–1.0) compared to photograph AUC 0.85 (95% 0.73–0.96) and VF AUC 0.86 (95% 0.76–0.96), suggestive of closer performance to that of a group of glaucoma specialists. Compared to VF and disc photography, SD-OCT, when used alone, had better internal agreement as well as better agreement with the consensus of clinicians using all available data. Future studies should evaluate best practices for SD-OCT interpretation.
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影响因子：
4.2
作者：
Zhang X;Loewen N;Tan O;Greenfield DS;Schuman JS;Varma R;Huang D;Advanced Imaging for Glaucoma Study Group
通讯作者：
Advanced Imaging for Glaucoma Study Group
影响因子：
17.8
作者：
Hood DC;Raza AS;de Moraes CG;Liebmann JM;Ritch R
通讯作者：
Ritch R
影响因子：
4.4
作者：
Lisboa, Renato;Paranhos, Augusto, Jr.;Medeiros, Felipe A.
通讯作者：
Medeiros, Felipe A.
影响因子：
2
作者：
Vessani, Roberto M.;Moritz, Rodrigo;Susanna, Remo
通讯作者：
Susanna, Remo
影响因子：
--
作者：
Medeiros, Felipe A.;Alencar, Luciana M.;Zangwill, Linda M.;Bowd, Christopher;Sample, Pamela A.;Weinreb, Robert N.
通讯作者：
Weinreb, Robert N.