Utility of hard exudates for the screening of macular edema.
Utility of hard exudates for the screening of macular edema.
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DOI：
10.1097/opx.0000000000000205
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发表时间：
2014-04
期刊：
影响因子：
--
通讯作者：
Gast TJ
中科院分区：
文献类型：
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作者：
Litvin TV;Ozawa GY;Bresnick GH;Cuadros JA;Muller MS;Elsner AE;Gast TJ
确定中心凹一个椎间盘直径内的硬渗出物 (HE) 是否是在筛查环境中转诊疑似临床显着黄斑水肿 (CSME) 的糖尿病患者的可接受标准。在加利福尼亚州奥克兰阿拉米达县医疗中心，使用免散瞳数字眼底相机对 143 名被诊断患有糖尿病的成年人进行了成像。两名分级员根据 EyePACS 分级方案，对黄斑中心附近是否存在 HE 的非立体眼底图像进行独立分级。患者还在单独就诊时接受了散瞳眼底检查。 CSME 是在散瞳眼底检查期间使用早期治疗糖尿病视网膜病变研究提出的标准确定的。随后，计算了非立体数字图像中小凹一圆盘直径内硬渗出物的敏感性和特异性，该图像用作检测通过实时眼底检查诊断的 CSME 的替代方法。分析中纳入的 103 名患者的平均年龄为 56±17 岁。在散瞳检查期间，15.5% 的眼睛被诊断出 CSME。对于右眼，每位分级者将距中心凹一圆盘直径范围内的硬性渗出物作为检测 CSME 的替代指标，敏感性为 93.8%；特异性分别为88.5%和85.1%。对于左眼，两位评分者的敏感度分别为 93.8% 和 75%；两位评分者的特异性均为 87.4%。这项研究支持在非立体数字图像中使用黄斑中心圆盘直径内的 HE 在筛查环境中进行 CSME 检测。
To determine whether hard exudates (HE) within one disc diameter of the foveola is an acceptable criterion for the referral of diabetic patients suspected of clinically significant macular edema (CSME) in a screening setting. 143 adults diagnosed with diabetes mellitus were imaged using a non-mydriatic digital fundus camera at the Alameda County Medical Center in Oakland, CA. Non-stereo fundus images were graded independently for the presence of HE near the center of the macula by two graders according to the EyePACS grading protocol. The patients also received a dilated fundus exam on a separate visit. CSME was determined during the dilated fundus examination using the criteria set forth by the Early Treatment Diabetic Retinopathy Study. Subsequently, the sensitivity and specificity of hard exudates within one disc diameter of the foveola in non-stereo digital images used as a surrogate for the detection of CSME diagnosed by live fundus examination were calculated. The mean age of 103 patients included in the analysis was 56±17years. CSME was diagnosed in 15.5% of eyes during the dilated exam. For the right eyes, the sensitivity of hard exudates within one disc diameter from the foveola as a surrogate for detecting CSME was 93.8% for each of the graders; the specificity was 88.5% and 85.1%. For the left eyes, the sensitivity was 93.8% and 75% for each of the two graders, respectively; the specificity was 87.4% for both graders. This study supports the use of HE within a disk diameter of the center of the macula in non-stereo digital images for CSME detection in a screening setting.