Comparison between ophthalmoscopy and fundus photography in determining severity of diabetic retinopathy.
Comparison between ophthalmoscopy and fundus photography in determining severity of diabetic retinopathy.
复制标题
检眼镜检查和眼底照相在确定糖尿病视网膜病变严重程度方面的比较。
DOI：
10.1016/s0161-6420(85)34082-4
复制
发表时间：
1985
期刊：
影响因子：
13.7
通讯作者：
Richie,KA
中科院分区：
文献类型：
--
作者：
Moss,SE;Klein,R;Kessler,SD;Richie,KA
对威斯康星州南部2708名糖尿病患者进行了一项基于人群的研究，评估了糖尿病视网膜病变。本文比较了1949例患者眼底立体照片分级与检眼镜检查视网膜病变的程度。眼底检查由一名眼科医生和一名受过专门训练的验光师和眼科技师进行。三位主考人之间的协商是允许的。检眼镜与分级诊断视网膜病变(无、非增殖性、增殖性)的符合率为85.7%。卡帕统计数据(对偶然性协议进行了修正)为0.749。三位检眼镜医师之间差异无统计学意义。在视网膜病变程度较轻的眼睛和研究早期检查的患者中，眼底镜检查更有可能与眼底摄影分级不一致。其他被发现影响一致性程度的因素还有年龄、视力和糖尿病病程。结论：在某些情况下，通过适当的训练，眼底镜检查可以作为眼底照相的一种可接受的替代方法。
Diabetic retinopathy was assessed in a population-based study of 2708 diabetic persons in southern Wisconsin. The retinopathy levels as determined by opthalmoscopy and by the grading of stereoscopic fundus photographs were compared in the eyes of 1949 persons. Ophthalmoscopy was performed by an ophthalmologist and a specially trained optometrist and ophthalmic technician. Consultation among the three examiners was permitted. There was exact agreement between ophthalmoscopy and grading for detecting retinopathy (none, nonproliferative, proliferative) 85.7% of the time. The kappa statistic, which corrects for chance agreement, was 0.749. There were no significant differences among the three ophthalmoscopists. Ophthalmoscopy was more likely to disagree with fundus photography grading in eyes with less severe forms of retinopathy and in patients examined early in the study. Other factors found to influence the degree of agreement were age, visual acuity, and duration of diabetes. It is concluded that with proper training ophthalmoscopy can be an acceptable alternative to fundus photography in certain situations.