单视野免散瞳数码眼底照相筛查糖尿病视网膜病变敏感性和特异性

The Sensitivity and Specificity of One-field,Non-mydriatic,45° Digital Photography for Diabetic Retinopathy Screening

目的评价单视野免散瞳45°眼底照相与裂隙灯间接眼底镜相比,检出糖尿病视网膜病变的敏感性和特异性,是否达到英国糖尿病协会的糖尿病视网膜病变筛查标准(敏感性>80%,特异性>95%,技术失败率<5%)。方法对同时行免散瞳眼底照相及眼科专家散瞳间接眼底镜检查的73名2型糖尿病患者的资料进行分析,以眼科专家间接眼底镜诊断结果作为参考标准,评价眼底照相的敏感性和特异性。结果眼底照相检出糖尿病视网膜病变的敏感性和特异性分别为83.9%和89.9%,检出需眼科进一步检查和治疗的糖尿病视网膜病变的敏感性和特异性分别为45.5%和100%,将眼底照相需眼科进一步检查和治疗的标准下调至中度非增生期后,其敏感性和特异性分别为95.5%和84.2%。结论单视野免散瞳眼底照相是糖尿病视网膜病变筛查的有效工具,采用该方法筛查基本达到英国糖尿病协会的糖尿病视网膜病变筛查标准。

Objective To evaluate the sensitivity and specificity of one - field non - mydriatic, 45odigital photography for diabetic retinopathy screening, compared with indirect ophthalmoscopy using slit - lamp biomicroscopy, to see if it meets the reference standard, for an effective screening program proposed by the British Diabetic Association（BDA） （sensitivity values of 〉 80% , specificity values ot〉 95% ,with a technical failure rate of 〈 5% ） .9 Methods Analyses the reference of 73 patients of type 2 diabetic who have been underwent 450, non - mydriatie, digital fundus photography using a non - mydriatie fundus camera, and dilation of their pupils, and sllt - lamp biomicroscopy done by an ophthalmologist. The sensitivity and specificity of the digital photographic method were calculated with,in orderto compare with the reference method. Results The sensitivhy and specificity of one - field,non - mydriatic,45odigital photography for detection of any diabetic retinopathy were 83.9% and 89.9% ,and the technical failure rate was 6.9%. The sensitivity and specificity for detection of referable diabetic retinopathy were 45.5% and 100%. After the standard for referable diabetic retinopathy being lowed down to the mod- erate non - proliferative diabetic retinopathy,the sensitivity and specificity were 95.5% and 84.2% ,respectively. Conclusions One - field,non- mydriatic,45odigital photography is an effective method for diabetic retinopathy screening, and roughly meets the reference standavd for an effective screening program. Proposed by the British Diabetic Association（BDA）.