Nonmydriatic Ultra-Widefield Fundus Photography in a Hematology Clinic Shows Utility for Screening of Sickle Cell Retinopathy
Nonmydriatic Ultra-Widefield Fundus Photography in a Hematology Clinic Shows Utility for Screening of Sickle Cell Retinopathy
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DOI：
10.1016/j.ajo.2021.10.030
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发表时间：
2022-01-05
影响因子：
4.2
通讯作者：
Scott, Adrienne W.
中科院分区：
文献类型：
--
作者：
Ahmed, Ishrat;Pradeep, Tejus;Scott, Adrienne W.
目得：为了确定的可行性和准确性的非散瞳超宽视野（UWF）眼底照片在血液学诊所设置筛选镰状细胞性视网膜病变（SCR）设计：前瞻性队列study.METHODS：这一单一网站的研究发生在约翰霍普金斯镰状细胞中心成人和威尔默眼科研究所。研究人群为连续46例患有镰状细胞病（SCD）的成人的90只眼。由威尔默眼科研究所的2名不知情的视网膜专家对参与者在常规血液学预约期间由诊所人员拍摄的双侧非散瞳眼底照片进行分级，以确定是否存在非增殖性SCR（NPSR）和增殖性镰状视网膜病变（PSR）。第三个视网膜专家裁定的情况下，分级分歧。所有参与者在获得UWF照片后2年内接受标准散瞳眼底检查（DFE）。主要的结果测量是非散瞳UWF图像检测NPSR和PSR的敏感性和特异性。结果：90只接受DFE的眼睛中有19只注意到PSR，67只可分级UWF图像中有9只注意到PSR。2名分级者之间的评定者间一致性为中等，PSR的kappa = 0.65（范围0.43-0.87）。对于可分级UWF照片，与DFE相比，使用非散瞳照片检测SCR的敏感性和特异性分别为85.2%和62.5%，用于检测PSR的敏感性和特异性分别为69.2%和100%。一名参与者需要在两个眼睛积极sea-fan neovascularization.CONCLUSIONS：UWF成像显示实用程序在筛选SCR，并可能有助于确定患者PSR谁需要DFE，谁可能受益于治疗。(C)2021爱思唯尔公司All rights reserved.
PURPOSE: To determine the feasibility and accuracy of nonmydriatic ultra-widefield (UWF) fundus photographs taken in a hematology clinic setting for screening of sickle cell retinopathy (SCR)DESIGN: Prospective cohort study.METHODS: This single-site study took place at the Johns Hopkins Sickle Cell Center for Adults and the Wilmer Eye Institute. The study population was 90 eyes of 46 consecutive adults with sickle cell disease (SCD). Bilateral nonmydriatic fundus photos taken by clinic personnel during the participants' routine hematology appointment were graded by 2 masked retina specialists at the Wilmer Eye Institute for the presence of nonproliferative SCR (NPSR) and proliferative sickle retinopathy (PSR). A third retina specialist adjudicated in cases of grader disagreement. All participants underwent the standard dilated fundus examination (DFE) within 2 years of acquisition of UWF photographs. The main outcome measure was the sensitivity and specificity of nonmydriatic UWF images for the detection of NPSR and PSRRESULTS: PSR was noted in 19 of 90 eyes that underwent DFE and in 9 of 67 gradable UWF images. Interrater agreement between the 2 graders was moderate, with kappa = 0.65 (range 0.43-0.87) for PSR. For gradable UWF photos, the sensitivity and specificity of detecting SCR using the nonmydriatic photos compared with the DFE were 85.2% and 62.5% for NPSR, respectively, and 69.2% and 100% for detection of PSR, respectively. One participant required ophthalmic therapy in both eyes for active sea-fan neovascularization.CONCLUSIONS: UWF imaging shows utility in screening for SCR and may help identify patients with PSR who require a DFE and who may benefit from treatment. (C) 2021 Elsevier Inc. All rights reserved.