Optos wide-field imaging versus conventional camera imaging in Danish patients with type 2 diabetes
Optos wide-field imaging versus conventional camera imaging in Danish patients with type 2 diabetes
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DOI：
10.1111/aos.14118
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发表时间：
2019-12-01
影响因子：
3.4
通讯作者：
Lund-Andersen, Henrik
中科院分区：
文献类型：
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作者：
Byberg, Stine;Vistisen, Dorte;Lund-Andersen, Henrik
目的糖尿病视网膜病变（DR）筛查方法成本高，需要专业人员和患者配合。Optos设备可以由非专业人员操作，并提供超宽视场成像，在一张图像中可以看到200度的视网膜视图。我们比较了Optos成像获得的DR分级与传统Topcon成像获得的DR分级。方法我们对101名糖尿病患者进行了横断面研究，这些患者参加了add - dk 10年随访研究。采用Optos和Topcon两种成像技术对双眼进行视网膜眼底成像。所有照片均由眼科专科护士使用改良版的“建议国际临床DR严重程度量表”进行评分。我们构建了频率表，并使用加权Kappa统计分别对外周和黄斑评分进行了Optos和Topcon评分之间的一致性评估。我们使用分层Wilcoxon检验来检验两个摄像机之间的一致性是否显著不同。结果与Topcon相比，Optos识别出的周围病变更多（p < 0.01）， Kappa符合率为0.21。我们发现两种相机在黄斑区的分级上没有显著差异（p = 0.97）。虽然两种相机之间的黄斑图像分级差异仅为7%，但黄斑分级Kappa一致性仅为中等（Kappa = 0.52）。结论相机间一致性可用于黄斑图像分级，但仅适用于外周图像分级，Optos可识别更多外周微血管变化。临床意义及对筛查方式和频率的影响有待探讨。
Purpose Diabetic retinopathy (DR) screening methods are costly, requiring specialized personnel and patient mydriasis. The Optos apparatus can be operated by nonspecialists and provides ultra-wide-field imaging, with 200 degrees views of the retina in a single image. We compared DR grading obtained from Optos imaging with DR grading from conventional Topcon imaging. Methods We conducted a cross-sectional study of 101 persons with diabetes who participated in the Addition-DK 10-year follow-up study. Retina fundus photos using both Optos and Topcon imaging were taken for both eyes. All photos were graded by specialist ophthalmologic nurses, using a modified version of the 'Proposed International Clinical DR severity scale'. We constructed frequency tables and assessed levels of agreement between Optos and Topcon gradings using weighted Kappa statistics, separately for peripheral and macular grading. We tested if the agreements between the two cameras were significantly different using a stratified Wilcoxon test. Results Significantly, more lesions in the periphery were identified by Optos compared with Topcon (p < 0.01), resulting in a fair Kappa agreement of 0.21. We saw no significant differences in the grading of the macula region (p = 0.97) between the two cameras. Although only 7% of the macula image gradings differed between the cameras, the Kappa agreement of macula grading was only moderate (Kappa = 0.52). Conclusion The inter-camera agreement was acceptable for macula image grading, but only fair for peripheral grading, with Optos identifying more microvascular changes in the periphery. The clinical significance and impact on screening modality and frequency remain to be explored.