摘要目的 评价超声检查伴玻璃体积血的急性症状性玻璃体后脱离视网膜撕裂的可靠性.方法 回顾性分析2015年1月至2017年12月的80例(80眼)急性症状性玻璃体后脱离的临床资料.对所有患者均行超声检查与间接检眼镜检查,以间接检眼镜检查结果作为金标准进行对两种检测结果进行对比.结果 检测到13例(16.25％)具有视网膜撕裂超声特征的膜性病变.间接检眼镜眼底检查证实了8例的诊断,并进行激光光凝.其余5例检测到局部玻璃体凝缩.其中1例玻璃体凝缩,由于继发性视网膜牵引改变进行了光凝.敏感性为100.00％(95％CI,60.14％-100.00％),特异性为93.06％(95％CI,58.51％-97.82％),阳性预测值61.53％(95％CI,32.82％-85.76％)和阴性预测值100.00％(95％CI,93.09％-100.00％).阳性似然比(positive likelihood ratio,PLR)为13.41(95％CI,5.82-31.14),阴性似然比(negative likelihood ration,NLR)为0.结论 超声检测玻璃体积血急性症状性玻璃体后脱离视网膜撕裂具有较高的灵敏度和阴性预测值,用于排除视网膜撕裂可靠性高.

abstractsObjective To evaluate the reliability of ultrasonic examination of vitreous hemorrhage after acute symptomatic posterior vitreous detachment of retinal tear. Methods The data of 80 eyes of 80 patients with acute symptomatic posterior vitreous detachment from Jan. 2015 to Dec. 2017 were analyzed retrospectively. Ultrasound examination and indirect ophthalmoscopy were performed on all patients. The results of the indirect ophthalmoscope examination were used as the gold standard to compare the results of the two tests. Results Membrane lesions characterized by retinal tear ultrasound were described in 13 patients (16. 25％). Fundus indirect ophthalmoscopy examination confirmed the diagnosis of 8 patients and they recived laser photocoagulation. The local vitreous condensation was detected in other 5 cases. One case received laser photocoagulation due to secondary changes in retinal traction. Sensitivity was 100. 00％ (95％CI, 60. 14％ -100. 00％), specificity was 93. 06％ (95％ CI, 58. 51％ -97. 82％), positive predictive value was 61. 53％ (95％ CI, 32. 82％ -85. 76％)and negative predictive value was 100. 00％ (95％ CI, 93. 09％ -100. 00％). The positive likelihood ratio was 13. 41 (95％ CI, 5. 82-31. 114) and the negative likelihood ratio was 0. Conclusion Ultrasonography has high sensitivity and negative predictive value in the detection of vitreous hemorrhage after acute symptomatic posterior vitreous detachment of the retina, and is used to exclude high reliability of retinal tear.