Sensitivity and specificity of high-resolution wide field fundus imaging for detecting neovascular age-related macular degeneration
Sensitivity and specificity of high-resolution wide field fundus imaging for detecting neovascular age-related macular degeneration
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DOI：
10.1371/journal.pone.0238072
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发表时间：
2020-08-21
期刊：
影响因子：
3.7
通讯作者：
Kadonosono, Kazuaki
中科院分区：
文献类型：
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作者：
Maruyama-Inoue, Maiko;Kitajima, Yoko;Kadonosono, Kazuaki
目的早期发现和治疗是新生血管性年龄相关性黄斑变性（AMD）的重要治疗策略。本研究的目的是确定使用两种宽视野成像系统检测新生血管性AMD的灵敏度和特异性：Clarus（TM）（XNUMUS 500（TM），Carl Zeiss Meditec AG，Jena，德国）和Optos（R）（Optos加州（R），Optos PLC，Dunfermline，英国），与传统的数字眼底照片进行比较。方法我们回顾性分析了连续73例新生血管性AMD患者的109只眼，这些患者接受了标准检查和多模式成像，包括眼底照相和光学相干断层扫描（OCT）。未设盲的分级者利用裂隙灯生物显微镜和OCT诊断新生血管性AMD。戴面具的分级者评估Clarus（TM）、Optos（R）和数字眼底照相方法，以确定是否存在与AMD相关的脉络膜新生血管。使用联合眼底镜检查和OCT作为参考标准进行敏感性和特异性分析。结果90只眼诊断为新生血管性AMD，19只眼为正常。其中新生血管性AMD的检出率为94.4%（85/90）。Optos（R）和数字眼底照相的敏感性分别为81.1%（73/90）和87.8%（79/90）。Clarus（TM）、Optos（R）和数字眼底照片的特异性分别为89.5%（17/19）、94.7%（18/19）和89.5%（17/19）。结论Claru（TM）眼底成像分辨率高，视野宽，对新生血管性AMD的诊断具有上级优势，敏感性高，特异性强。它可能是一个有用的筛选工具，早期发现新生血管性AMD，促进及时转诊和治疗。
Purpose Early detection and treatment are important management strategies for neovascular age-related macular degeneration (AMD). The purpose of this study was to determine the sensitivity and specificity in detecting neovascular AMD using two wide-field imaging systems: Clarus(TM)(CLARUS 500 (TM), Carl Zeiss Meditec AG, Jena, Germany) and Optos(R)(Optos California(R), Optos PLC, Dunfermline, United Kingdom), compared to conventional digital fundus photographs. Methods We retrospectively analyzed 109 eyes of 73 consecutive patients with neovascular AMD, who underwent standard examination and multimodal imaging, including fundus photography, and optical coherence tomography (OCT). Unmasked graders utilized slit-lamp biomicroscopy and OCT to diagnose neovascular AMD. Masked graders evaluated Clarus(TM), Optos(R), and digital fundus photograph methods to determine the presence of choroidal neovascularization associated with AMD. Sensitivity and specificity analyses were performed using combined fundoscopy and OCT as the reference standard. Results Ninety eyes were diagnosed with neovascular AMD and the remaining 19 eyes were normal based on the reference standard. Of these, neovascular AMD was detected using Clain 94.4% (85/90). The sensitivities of Optos(R)and digital fundus photographs were 81.1% (73/90) and 87.8% (79/90), respectively. The specificities using Clarus(TM), Optos(R), and digital fundus photographs were 89.5% (17/19), 94.7% (18/19), and 89.5% (17/19), respectively. Conclusion Claru(TM), with its ability to image high-resolution wide field fundus, was considered superior for diagnosing neovascular AMD with high sensitivity and specificity. It may be a useful screening tool for early detection of neovascular AMD, facilitating prompt referral and treatment.