Diabetic retinopathy as detected using ophthalmoscopy, a nonmydriatic camera and a standard fundus camera.
Diabetic retinopathy as detected using ophthalmoscopy, a nonmydriatic camera and a standard fundus camera.
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使用检眼镜、免散瞳相机和标准眼底相机检测到的糖尿病视网膜病变。
DOI：
10.1016/s0161-6420(85)34003-4
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发表时间：
1985
期刊：
影响因子：
13.7
通讯作者：
Brothers,RJ
中科院分区：
文献类型：
--
作者：
Klein,R;Klein,BE;Neider,MW;Hubbard,LD;Meuer,SM;Brothers,RJ
该研究旨在评估通过三种替代方法评估的糖尿病视网膜病变的严重程度是否与通过 30° 立体照片确定的视网膜病变的严重程度一致。这三种方法是通过未散瞳的直接检眼镜检查、通过药理学未散瞳的非立体45°视网膜摄影和通过散瞳的非立体45°摄影。在药物散瞳之前，对 99 人拍摄了一张以椎间盘和中央凹为中心的 45° 照片，并进行了直接检眼镜检查。扩张后，对同一视场拍摄另一张 45° 照片，以及 DRS 视场 1、2 和 4（修改后）的 30° 立体彩色照片。相应的照相视野由蒙面、训练有素的分级员使用改良的艾尔利屋分类方案针对视网膜病变的严重程度和特定糖尿病病变的存在进行分级。对于视网膜病变的三个严重程度（无、非增殖性或增殖性），直接检眼镜检查与标准 30° 相机拍摄的立体照片的视网膜病变分级之间的精确一致性为 54.3% (n = 94)。对于视网膜病变的四个严重程度（无、仅微动脉瘤、所有其他非增殖性视网膜病变和增殖性视网膜病变），通过未散瞳拍摄的 45° 照片和通过散瞳拍摄的 30° 照片的视网膜病变分级之间的精确一致性为 82.5% (n = 63)；对于 45° 照片和通过扩张瞳孔拍摄的 30° 照片，该比例为 86.5% (n = 74)：这些数据表明，当根据标准分类方案进行分级时，45° 非立体眼底照片在使用广泛的总体类别时可以提供相当可靠的视网膜病变严重程度的照片表示。
The study was performed to evaluate whether the severity of diabetic retinopathy as assessed by three alternative methods was concordant with the severity of retinopathy as determined from 30° stereoscopic photographs. The three methods were direct ophthalmoscopy through an undilated pupil, nonstereoscopic 45° retinal photography through a pharmacologically undilated pupil and nonstereoscopic 45° photography through a dilated pupil. A single 45° photograph centered between the disc and fovea was taken and direct ophthalmoscopy was performed on 99 persons prior to pharmacological dilation of the pupil. After dilation, another 45° photograph was taken of the same field, as well as 30° stereoscopic color photographs of DRS fields 1, 2 and 4 (modified). Corresponding photographic fields were graded by masked, trained graders for the severity of retinopathy and for the presence of specified diabetic lesions using the Modified Airlie House Classification scheme. For three levels of severity of retinopathy (none, nonproliferative or proliferative) exact agreement between direct ophthalmoscopy and grading of retinopathy from stereoscopic photographs taken with the standard 30° camera was 54.3% (n = 94). For four levels of severity of retinopathy (none, microaneurysms only, all other nonproliferative retinopathy and proliferative retinopathy), exact agreement between gradings of retinopathy of the 45° photographs taken through undilated pupils and 30° photographs taken through dilated pupils was 82.5% (n = 63); and for 45° photographs and 30° photographs taken through dilated pupils it was 86.5% (n = 74): These data suggest that 45° nonstereoscopic fundus photographs, when graded according to a standard classification scheme, provide reasonably reliable photographic representation of the severity of retinopathy when broad overall categories are used.