The sensitivity and specificity of nonmydriatic digital stereoscopic retinal imaging in detecting diabetic retinopathy
The sensitivity and specificity of nonmydriatic digital stereoscopic retinal imaging in detecting diabetic retinopathy
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DOI：
10.2337/dc06-0295
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发表时间：
2006-10-01
期刊：
影响因子：
16.2
通讯作者：
Vigersky, Robert A.
中科院分区：
文献类型：
--
作者：
Ahmed, Jehanara;Ward, Thomas P.;Vigersky, Robert A.
目的-本研究的目的是确定乔斯林视觉网络非散瞳数字立体视网膜成像（NMDSRI）作为检测糖尿病视网膜病变的筛查工具的敏感性和特异性。研究设计和方法-我们回顾了244例糖尿病患者的记录，他们进行了散瞳眼底镜检查（DFE）。和NMDSRI在一年内在大都市华盛顿特区的四个地点完成。图像通过局域网传输到一个中央阅读的位置，在那里他们被分级由一个单一的视网膜specialist. Results-Images的482只眼睛，从243例患者被列入研究。4张图像未传输，35%的图像无法分级。在其余311只眼中，NMDSRI和DFE之间的分级有86%的一致性：227只眼无糖尿病视网膜病变，40只眼有糖尿病视网膜病变。在46只眼睛（15%）有两种技术之间的分级不一致。NMDSRI检测到糖尿病视网膜病变的35只眼睛报告为正常的DFE，和在其余的II眼睛，DFE等级是一个等级高于NMDSRI等级。判定的不一致检查在一个等级内。在76只患糖尿病视网膜病变的眼睛中，17只（21%）眼睛的视网膜厚度无法评估。当NMDSRI结果可分级时，在DFE的一个等级内，NMDSRI的总体敏感性为98%，特异性为100%。在有限数量的糖尿病视网膜病变伴黄斑水肿（6只眼）中，与临床检查的一致率为100%.CONCLUSIONS - NMDSRI是筛查和诊断糖尿病视网膜病变的敏感和特异性方法，有助于提高糖尿病患者对眼科护理标准的依从性。
OBJECTIVE - The objective of this study was to determine the sensitivity and specificity of Joslin Vision Network nonmydriatic digital stereoscopic retinal imaging (NMDSRI) as a screening tool in detecting diabetic retinopathy.RESEARCH DESIGN AND METHODS - We reviewed the records of 244 patients with diabetes who had a dilated funduscopic examination (DFE) and NMDSRI done within I year of each other at four locations in the metropolitan Washington, DC, area. The images were transmitted through a local area network to a central reading location where they were graded by a single retinal specialist.RESULTS - Images of 482 eyes from 243 patients were included in the study. Four images did not transmit, and 35% of the images were not gradable. Of the remaining 311 eyes, there was 86% agreement in the grading between NMDSRI and DFE: 227 eyes with no diabetic retinopathy and 40 eyes with diabetic retinopathy. In 46 eyes (15%) there was a disagreement between gradings made by the two techniques. NMDSRI detected diabetic retinopathy in 35 eyes reported as normal by DFE, and in the remaining II eyes, the DFE grade was one grade higher than the NMDSRI grade. Adjudicated nonconcordant examinations were within one grade. In the 76 eyes with diabetic retinopathy, retinal thickness could not be assessed in 17 (21%) eyes. When the NMDSRI result was gradable, the overall sensitivity of NMDSRI was 98% and the specificity was 100% for retinopathy within one grade of the DFE. In the limited number of eyes that had diabetic retinopathy with macular edema (six), agreement with the clinical examination was 100%.CONCLUSIONS - NMDSRI is a sensitive and specific method for the screening and diagnosis of diabetic retinopathy, which may help improve compliance with the standards of eye care for patients with diabetes.