Combining Optical Coherence Tomography and Fundus Photography to Improve Glaucoma Screening.
Combining Optical Coherence Tomography and Fundus Photography to Improve Glaucoma Screening.
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DOI：
10.3390/diagnostics12051100
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发表时间：
2022-04-27
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我们的目的是评估眼底照相结合光学相干断层扫描筛查青光眼的准确性，并确定眼科医生和眼科住院医生之间的一致性。我们使用了503例(1006只眼)的综合眼科检查数据集。在1006只眼睛中，132只眼睛被确诊为青光眼。总体而言，24名医生，包括两组(眼科医生和眼科住院医生，12人/组)分析了以下三种筛查策略中提供的数据：(1)单独的眼底照相，(2)眼底照相+光学相干断层扫描，和(3)眼底照相+光学相干断层扫描+综合检查。我们调查了诊断的准确性(敏感性和特异性)。24名医生、12名眼科医生和12名眼科住院医师的敏感度和特异度分别为：(1)眼底照相：敏感度，55.4%，55.4%，55.4%；特异度，91.8%，94.0%，89.6%；(2)眼底照相+OCT：敏感度，80.0%，82.3%，77.8%；(3)眼底摄影+OCT+综合检查：敏感性78.4%、79.8%、77.1%，特异性92.7%、94.0%、91.3%。光学相干断层扫描对青光眼筛查的诊断准确率显著提高。加入后，眼科医生可以比眼科住院医生更有效地提高诊断准确率。在眼底照相中加入光学相干层析成像，可提高筛查精度。
We aimed to evaluate the accuracy of glaucoma screening using fundus photography combined with optical coherence tomography and determine the agreement between ophthalmologists and ophthalmology residents. We used a comprehensive ophthalmologic examination dataset obtained from 503 cases (1006 eyes). Of the 1006 eyes, 132 had a confirmed glaucoma diagnosis. Overall, 24 doctors, comprising two groups (ophthalmologists and ophthalmology residents, 12 individuals/group), analyzed the data presented in three screening strategies as follows: (1) fundus photography alone, (2) fundus photography + optical coherence tomography, and (3) fundus photography + optical coherence tomography + comprehensive examination. We investigated the diagnostic accuracy (sensitivity and specificity). The respective sensitivity and specificity values for the diagnostic accuracy obtained by 24 doctors, 12 ophthalmologists, and 12 ophthalmology residents were as follows: (1) fundus photography: sensitivity, 55.4%, 55.4%, and 55.4%; specificity, 91.8%, 94.0%, and 89.6%; (2) fundus photography + OCT: sensitivity, 80.0%, 82.3%, and 77.8%; specificity, 91.7%, 92.9%, and 90.6%; and (3) fundus photography + OCT + comprehensive examination: sensitivity 78.4%, 79.8%, and 77.1%; specificity, 92.7%, 94.0%, and 91.3%. The diagnostic accuracy of glaucoma screening significantly increased with optical coherence tomography. Following its addition, ophthalmologists could more effectively improve the diagnostic accuracy than ophthalmology residents. Screening accuracy is improved when optical coherence tomography is added to fundus photography.
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