七方位彩色眼底照像法对糖尿病视网膜病变的诊断价值

Grading of 7-standard field fundus photography for diagosis of diabetic retinopathy

目的筛选经济、简便、有效地糖尿病视网膜病变检查法。方法分别采用散瞳50度眼底后极部彩色照像法、美国早期糖尿病性视网膜病变治疗研究小组确立的散瞳30度眼底七方位彩色照像法和FFA法对164例（308只眼）糖尿病患者进行检查，由有经验的眼底医生按照糖尿病视网膜病变国际临床分类法对图片进行分析给出分期，对三种方法所得结果进行比较。结果散瞳50度眼底后极部彩色照像法和FFA法在DR诊断分期中一致性一般（K=O．488），七方位彩色眼底照像法和FFA法在DR诊断分期中有比较好的一致性（K=0．873）。结论七方位彩色眼底照像法可作为糖尿病视网膜病变筛查和指导治疗的一种比较可靠的方法，而散瞳50度眼底后极部彩色照像法的可靠性一般。

Objective To evaluate the ability ofmydriatic single-field 50° digital fundus photogra- phy and mydriatic 7-standard field fundus photography to detect diabetic retinopathy （DR）in patients with dia- betic mellitus （DM）compared with fluorescein fundus angiography （FFA）.Methods A Total of 164 diabetic patients attending a hospital-based screening clinic were recruited.Mydriatic single-field 50° digital fundus photography,mydriatic 7-standard field ETDRS fundus photography and FFA were performed using a Zeiss ff450 plus 1R fundus camera.Grading of diabetic retinopathy was carried out by two ophthalmologists with diabetic retinopathy international clinical classification.The results were evaluated and compared respectively.Re- suits Mydriafic single-field 50° digital fundus photography and FFA demonstrated moderate agreement （K =0.488）.Mydriatic 7-standard field fundus photography and FFA demonstrated near perfect agreement （K =0.873）.Conclusion Mydriatic 7-standard field fundus photography is an effective and clinically viable technique to screen for diabetic retinopathy among a diabetic population,Mydriatic single-field 50° digital fundus photography moderate.