糖尿病视网膜病变超广角荧光素眼底血管造影检查与标准7视野检查结果的对比分析
Comparative analysis of ultra-wide-field fluorescein angiography and early treatment diabetic retinopathy study 7 standard field photography in diabetic retinopathy
摘要目的对比观察糖尿病视网膜病变(DR)患眼超广角荧光素眼底血管造影(UWFA)检查图像与模拟标准7视野(7SF)检查图像所显示眼底病变特征的异同以及对DR分期判断的一致性。方法回顾性临床描述性研究。临床检查确诊的DR患者55例96只眼纳入研究。患者年龄25~73岁,平均年龄(41.34±15.07)岁。UWFA检查采用英国Optos 200Tx成像系统。根据DR早期治疗研究组的7SF检查取图规范,以7个30°范围的圆形区域进行拼接作为7SF模板确定其观察范围大小;将该模板覆盖在UWFA图像上,模拟7SF检查范围。由同一位专科医师对UWFA检查图像和模拟7SF检查图像中所显示视网膜可视面积以及视网膜无灌注(NP)区、视网膜新生血管(NV)区、全视网膜激光光凝(PRP)面积进行测量。对比观察UWFA检查图像与模拟7SF检查图像对DR分期判断的一致性以及视网膜可视面积和视网膜NP区、视网膜NV区、PRP面积大小定量测量结果的异同。结果 UWFA检查图像与模拟7SF检查图像对判断DR分期具有高度一致性(Kappa值=0.851,P=0.000)。与模拟7SF检查图像比较,UWFA检查图像所显示的视网膜可视面积以及视网膜NP区、视网膜NV区、PRP面积分别是前者的3.16、3.38、2.22、3.15倍(t=213.430、45.013、22.644、142.665,P=0.000、0.000、0.003、0.000)。模拟7SF检查图像范围外发现病变8只眼,其中周边视网膜NP区、视网膜NV区分别为5、3只眼。结论 UWFA检查图像与模拟7SF检查图像对判断DR分期具有一致性;UWFA检查图像可发现更多周边视网膜病变。
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abstractsObjective To observe the ocular fundus features and consistency of classification of diabetic retinopathy (DR) by ultra-wide-field fluorescein angiography (UWFA) and the simulated early treatment diabetic retinopathy study (ETDRS) 7 standard field (7SF) imaging. Methods This is a retrospective clinical description study. Ninety-six eyes of 55 DR patients were included. The ages ranged from 25 to 73 years, with a mean age of (41.34±15.07) years. UWFA examination (British Optos 200Tx imaging system) using the protocol for obtaining 7SF images as described in the ETDRS, 7 circular regions with a range of 30 degrees are spliced as 7SF templates to determine the observation range. This template was then overlaid on the UWFA image to identify the potential viewable area of 7SF. And the visualized area of the retina, retinal non-perfusion (NP) area, retinal neovascularization (NV) area, and pan-retinal photocoagulation (PRP) area of UWFA and 7SF were quantified by a retinal specialist. Results UWFA imaging and 7SF imaging have a high degree of consistency in judging DR classification (kappa=0.851, P=0.000). The retinal visual area, NP area, NV area and PRP area of the UWFA imaging were 3.16, 3.38, 2.22 and 3.15 times more comparing with the simulated 7SF imaging (t=213.430, 45.013, 22.644, 142.665;P=0.000, 0.000, 0.003, 0.000). The lesions of 8 eyes were found outside the range of simulated 7SF imaging, including peripheral NP in 5 eyes, NV areas in 3 eyes, respectively. Conclusion UWFA imaging and simulated 7SF imaging are consistent to judge DR classification, but UWFA can find more peripheral retinal lesions.
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