原发性青光眼OCT与FDT诊断准确性研究

Study of the diagnostic accuracy for primary glaucoma by OCT and FDT

目的:用诊断试验的方法,分析原发性青光眼视野与视网膜神经纤维层厚度改变,进一步验证倍频视野技术(frequency doubling technology,FDT)与光学相干断层扫描(optical coherence tomography,OCT)的诊断效能,比较两者在临床应用中的诊断价值。方法:设计一个前瞻性诊断试验,分别应用OCT和FDT对83例162只青光眼及疑似青光眼进行检测,根据检测结果得出各诊断试验的诊断指标,并对两者进行比较和联合试验。得出两者的验前和验后概率。结果:两者的灵敏度和特异度比较,均有P>0.05。两者的联合灵敏度为88.4%,诊断效能较单纯OCT提高了11.84%,较FDT提高了18.09%。联合特异度为84.42%,诊断效能较单纯OCT提高了29.32%,较FDT提高了19.11%。两者的验前概率为39.51%,验后概率分别为52.83%和57.08%。结论:OCT与FDT在诊断原发性青光眼的应用中有较好的诊断价值,且两者诊断效能的差异不大,两者联合可以大大提高其诊断价值。在临床应用中,还不能单纯依靠OCT或FDT的诊断结果来判定原发性青光眼,对原发性青光眼的诊断尚需进一步检查。

AIM：To investigate the accuracy of the two diagnostic test,and to compare the clinical diagnostic value of frequency doubling technology（FDT） and optical coherence tomography.·METHODS： Prospective diagnostic test was set up 83 cases （162 eyes） of glaucoma and suspect glaucoma were enrolled and examinated by OCT and FDT.To obtain studied indices by the consequences and compare and combine the two diagnostic tests.Finally,to analyze the two diagnostic tests＇ pre-test probability and post-test probability.·RESULTS： Comparing the sensitivity and the specificity of the two diagnostic tests ,the difference between them had not statistics meaning. The combined sensitivity were 88.4%,the diagnostic ability were increased 15.5% than OCT and 25.7% than FDT.The combined specificity were 84.42%,such increased 53.2% than OCT and 29.3% than FDT.OCT and FDT＇s pre-test probability were 39.51%,the post-test probability were 52.83% and 57.08%.·CONCLUSION： OCT and FDT had better diagnostic value in diagnosing primary glaucoma,and the difference between them was not apparent.OCT and FDT combine would increase diagnostic value considerably.But in clinical application,we could not only depend on the result of OCT and FDT to determine primary glaucoma and need to detect further.