The sensitivity and specificity of single-field nonmydriatic monochromatic digital fundus photography with remote image interpretation for diabetic retinopathy screening: A comparison with ophthalmoscopy and standardized mydriatic color photography
The sensitivity and specificity of single-field nonmydriatic monochromatic digital fundus photography with remote image interpretation for diabetic retinopathy screening: A comparison with ophthalmoscopy and standardized mydriatic color photography
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DOI：
10.1016/s0002-9394(02)01522-2
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发表时间：
2002-08-01
影响因子：
4.2
通讯作者：
Grosvenor, DM
中科院分区：
文献类型：
--
作者：
Lin, DY;Blumenkranz, MS;Grosvenor, DM
目得：评价单视野数字单色非散瞳眼底照相作为糖尿病视网膜病变筛查的辅助手段。设计：前瞻性、比较性、观察性病例系列。方法：I型和11型糖尿病患者（n = 197）依次采用三种不同的技术进行评价：单视野数字单色非散瞳眼底照相; 7项早期治疗糖尿病视网膜病变研究（ETDRS）标准化了35 mm彩色立体散瞳图像。七个立体结果：通过一张非散瞳单色数码照片检测到的视网膜病变程度与在7个标准35 mm彩色立体散瞳视野中观察到的视网膜病变程度之间存在高度显著的一致性（K = 0.97，P = 0.0001）。与彩色摄影相比，数码摄影的敏感性为78%，特异性为86%。散瞳检眼镜检查与7张标准35 mm彩色照片之间的一致性较差（K = 0.40，P =.0001）。结论：与散瞳眼底镜检查相比，单次非散瞳单色宽视野数字视盘和黄斑照片对糖尿病视网膜病变筛查的敏感性更高。当通过标准七场彩色照片判定时，数码摄影的较高灵敏度主要反映了检眼镜检查在检测早期视网膜病变方面的灵敏度降低。(C)2002年，Elsevier Science Inc. All rights reserved.
PURPOSE: To evaluate single-field digital monochromatic nonmydriatic fundus photography as an adjunct in the screening of diabetic retinopathy.DESIGN: Prospective, comparative, observational case series.METHODS: Patients with type I and type 11 diabetes mellitus (n = 197) were sequentially evaluated by three different techniques: single-field digital monochromatic nonmydriatic photography; dilated ophthalmoscopy by an ophthalmologist; and seven Early Treatment Diabetic Retinopathy Study (ETDRS) standardized 35-mm color stereoscopic mydriatic images. The seven stereoscopicRESULTS: There was highly significant agreement (K = 0.97, P =.0001) between the degree of retinopathy detected by a single nonmydriatic monochromatic digital photograph and that seen in seven standard 35 mm color stereoscopic mydriatic fields. The sensitivity of digital photography compared with color photography was 78%, with a specificity of 86%. Agreement was poor (K = 0.40, P =.0001) between mydriatic ophthalmoscopy and the seven field standard 35,mm color photographs. Sensitivity of ophthalmoscopy compared with color photography was 34%, with a specificity of 100%.CONCLUSION: A single nonmydriatic monochromatic wide,field digital photograph of the disk and macula was more sensitive for diabetic retinopathy screening than mydriatic ophthalmoscopy, the currently accepted screening method. When adjudicated by standard seven, field color photographs, the higher sensitivity of digital photography primarily reflected the reduced sensitivity of ophthalmoscopy in detecting early retinopathy. (C) 2002 by Elsevier Science Inc. All rights reserved.