直接检眼镜和彩色眼底照像及FFA在DME诊断中的应用研究

Application of DEG,CPF and FFA in diagnosing diabetic macular edema

目的:探讨直接检眼镜、彩色眼底照像及眼底荧光血管造影(fundus fluorescein angiography,FFA)在糖尿病视网膜病变黄斑水肿(diabetic macular edema,DME)中的诊断价值。方法:对50例100眼糖尿病视网膜病变患者散瞳后进行直接检眼镜、彩色眼底照像及FFA检查,以FFA为金标准,并将其分别与直接检眼镜及眼底照像结果进行一致性比较。结果:患者50例100眼中发现黄斑水肿45眼(45%),其中,直接检眼镜、眼底照像及FFA对黄斑水肿的检出分别为10眼(10%),35眼(35%),45眼(45%)。直接检眼镜与FFA的诊断吻合程度较差(K=0.239,P=0.00),而眼底照像与FFA的诊断吻合程度较高(K=0.794,P=0.00),具有显著统计学意义。结论:直接检眼镜、彩色眼底照像及FFA三种方法对诊断黄斑水肿都有一定的吻合性,但眼底照像与FFA的吻合程度更高,因此,对于一些无条件开展FFA检查的基层医院,眼底照像更为适用。

AIM ： To discuss the applied value of the methods of the direct examination of the glass （DEG）, the colored photograph of the fundus （CPF） and the fundus fluorescein angiography （FFA） in diagnosing the diabetic macular edema（DME）. METHODS： After distributing pupils,50 cases 100 eyes were checked with the methods of DEG, CPF and FFA. FFA was taken as the golden standard, and the results of DEG and CPF were compared with that of FFA. RESULTS： Totally 45 eyes （45%） of 100 eyes （50 cases） were found with DME by FFA. However, 10 eyes （10%） were found by DEG and 35 eyes （35%） found by CPF. The result of DEG was quite different from that of FFA （kappa = 0.239, P = 0.00）, while the result of CPF was similar to that of FFA （ kappa = 0.794, P = 0. 00） and had significantly statistical difference. CONCLUSION： These three methods can be used in diagnosing diabetic macular edema in some extent. CPF and FFA have the higher similarity. Therefore, the method of CPF is more suitable for those hospitals without FFA examination.