Fluorescein angiography versus optical coherence tomography for diagnosis of uveitic macular edema.
Fluorescein angiography versus optical coherence tomography for diagnosis of uveitic macular edema.
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DOI：
10.1016/j.ophtha.2013.01.069
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发表时间：
2013-09
期刊：
影响因子：
13.7
通讯作者：
Multicenter Uveitis Steroid Treatment (MUST) Trial Research Group
中科院分区：
文献类型：
--
作者：
Kempen JH;Sugar EA;Jaffe GJ;Acharya NR;Dunn JP;Elner SG;Lightman SL;Thorne JE;Vitale AT;Altaweel MM;Multicenter Uveitis Steroid Treatment (MUST) Trial Research Group
评估荧光素血管造影 (FA) 和光学相干断层扫描 (OCT) 诊断葡萄膜炎患者黄斑水肿的一致性。多中心横断面研究 255 名患者的 479 只患有葡萄膜炎的眼睛 通过 Stratus-3 OCT 和 FA 评估患有中间、后部或全葡萄膜炎的散瞳眼睛的黄斑状态。 Kappa 统计评估了诊断方法之间的一致性。黄斑增厚（每个 OCT 图像读取中心分级的中心点厚度≥240 μm -“MT”）和黄斑渗漏（每个 FA 图像读取中心分级的中心子场荧光素渗漏≥0.44 个圆盘区域 -“ML”）；这些结果在诊断“黄斑水肿”时一致。 OCT (90.4%) 比 FA (77%) 和生物显微镜检查 (76%) 更频繁地返回有关黄斑水肿的可用信息。 MT 和 ML 诊断的一致性（κ=0.44）中等。 40% 的无 MT 病例中存在 ML，而 34% 的无 ML 病例中存在 MT。黄斑水肿的生物显微镜评估未能检测到 MT 和 ML 病例，分别为 40% 和 45%，诊断出黄斑水肿但无 MT 或 ML 病例的比例分别为 17% 和 17%；这些结果可能低估了生物显微镜误差（眼科医生没有明确掩盖 OCT 和 FA 结果）。在没有 ML 的眼睛中，无白内障的有晶状体眼很少（4%）患有 MT。当 MT 不存在时，没有发现任何因素可以有效排除 ML。 OCT 和 FA 对于葡萄膜炎病例中的黄斑水肿状态仅提供中等程度的一致性，可能是因为它们测量的内容（MT 和 ML）是相关但不相同的黄斑病理。鉴于其成本较低、安全性较高以及获得可用信息的可能性较大，OCT 可能是评估疑似黄斑水肿的最佳初始测试。然而，考虑到如果没有 MT，则不能排除 ML，反之亦然，因此，当检测 ML 或 MT 会改变管理时，在第一次测试结果呈阴性后进行第二次测试似乎是合理的。鉴于黄斑水肿的生物显微镜评估经常出错，当 ML 或 MT 状态的知识会影响治疗时，似乎需要对黄斑水肿进行辅助检测。
To evaluate agreement between fluorescein angiography (FA) and optical coherence tomography (OCT) for diagnosis of macular edema in patients with uveitis. Multicenter cross-sectional study Four hundred seventy-nine eyes with uveitis of 255 patients The macular status of dilated eyes with intermediate, posterior or panuveitis was assessed via Stratus-3 OCT and FA. Kappa statistics evaluated agreement between the diagnostic approaches. Macular thickening (center point thickness ≥240 μm per reading center grading of OCT images-“MT”) and macular leakage (central subfield fluorescein leakage ≥0.44 disk areas per reading center grading of FA images-“ML”); agreement amongst these outcomes in diagnosing “macular edema.” OCT (90.4%) more frequently returned usable information regarding macular edema than FA (77%) and biomicroscopy (76%). Agreement in diagnosis of MT and ML (κ=0.44) was moderate. ML was present in 40% of cases free of MT, whereas MT was present in 34% of cases without ML. Biomicroscopic evaluation for macular edema failed to detect 40% and 45% of cases of MT and ML respectively and diagnosed 17% and 17% of cases with macular edema which did not have MT or ML respectively; these results may underestimate biomicroscopic errors (ophthalmologists were not explicitly masked to OCT and FA results). Among eyes free of ML, phakic eyes without cataract rarely (4%) had MT. No factors were found that effectively ruled out ML when MT was absent. OCT and FA offered only moderate agreement regarding macular edema status in uveitis cases, probably because what they measure (MT and ML) are related but non-identical macular pathologies. Given its lower cost, greater safety, and greater likelihood of obtaining usable information, OCT may be the best initial test for evaluation of suspected macular edema. However, given that ML cannot be ruled out if MT is absent and vice versa, obtaining the second test after a negative result on the first seems justified when detection of ML or MT would alter management. Given that biomicroscopic evaluation for macular edema frequently erred, ancillary testing for macular edema seems indicated when knowledge of ML or MT status would affect management.
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影响因子：
4.4
作者：
Pelosini, Lucia;Hull, Christopher C.;Marshall, John
通讯作者：
Marshall, John
黄斑水肿对中间，后膜炎和全膜炎的视觉功能的影响。
影响因子：
3.3
作者：
Taylor SR;Lightman SL;Sugar EA;Jaffe GJ;Freeman WR;Altaweel MM;Kozak I;Holbrook JT;Jabs DA;Kempen JH
通讯作者：
Kempen JH
影响因子：
--
作者：
Brown, JC;Solomon, SD;Bressler, NM
通讯作者：
Bressler, NM
影响因子：
4.2
作者：
Monnet, Dominique;Levinson, Ralph D.;Brezin, Antoine P.
通讯作者：
Brezin, Antoine P.
影响因子：
1.4
作者：
Marmor, MF
通讯作者：
Marmor, MF