Optomap ultrawide field imaging identifies additional retinal abnormalities in patients with diabetic retinopathy.
Optomap ultrawide field imaging identifies additional retinal abnormalities in patients with diabetic retinopathy.
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DOI：
10.2147/opth.s79448
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发表时间：
2015
期刊：
影响因子：
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通讯作者：
Chong NV
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文献类型：
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作者：
Price LD;Au S;Chong NV
比较Optomap超广角扫描激光检眼镜（UWFSLO）200°图像与早期治疗糖尿病视网膜病变研究（ETDRS）7标准视野之间的糖尿病视网膜病变（DR）严重程度分级。从眼科诊所就诊者数据库中回顾性选择Optomap UWFSLO图像（总计：266）作为DR证据。由两名设盲的评估者对Optomap UWFSLO图像的DR严重程度进行分级。将ETDRS七视野掩模覆盖在Optomap UWFSLO图像上，并评估掩模内区域的DR等级。任何评估者之间的差异均由高级视网膜专家裁定。Kappa一致性水平用于统计分析。与ETDRS七视野视图相比，Optomap UWFSLO视图中有50张图像（19%）（P<0.001）被分配了更高的DR级别，这导致40张图像（15%）（P<0.001）接受了更高的DR严重度等级。ETDRS七视野视图与Optomap UWFSLO视图中的DR严重度等级在85%（226）的图像中相同，在100%（266）的图像中在一个严重度等级内。两个视图之间的一致性很高：未加权κ为0.74±0.04（95%置信区间：0.67-0.81），加权κ为0.80±0.03（95%置信区间：0.74-0.86）。与ETDRS七视野视图相比，使用Optomap UWFSLO视图时，少数患者被诊断为更严重的DR。其他外周病变的临床意义需要在未来的前瞻性研究中使用大型队列进行评价。
To compare diabetic retinopathy (DR) severity grading between Optomap ultrawide field scanning laser ophthalmoscope (UWFSLO) 200° images and an Early Treatment Diabetic Retinopathy Study (ETDRS) seven-standard field view. Optomap UWFSLO images (total: 266) were retrospectively selected for evidence of DR from a database of eye clinic attendees. The Optomap UWFSLO images were graded for DR severity by two masked assessors. An ETDRS seven-field mask was overlaid on the Optomap UWFSLO images, and the DR grade was assessed for the region inside the mask. Any interassessor discrepancies were adjudicated by a senior retinal specialist. Kappa agreement levels were used for statistical analysis. Fifty images (19%) (P<0.001) were assigned a higher DR level in the Optomap UWFSLO view compared to the ETDRS seven-field view, which resulted in 40 images (15%) (P<0.001) receiving a higher DR severity grade. DR severity grades in the ETDRS seven-field view compared with the Optomap UWFSLO view were identical in 85% (226) of the images and within one severity level in 100% (266) of the images. Agreement between the two views was substantial: unweighted κ was 0.74±0.04 (95% confidence interval: 0.67–0.81) and weighted κ was 0.80±0.03 (95% confidence interval: 0.74–0.86). Compared to the ETDRS seven-field view, a significant minority of patients are diagnosed with more severe DR when using the Optomap UWFSLO view. The clinical significance of additional peripheral lesions requires evaluation in future prospective studies using large cohorts.