单视野免散瞳数码眼底照相筛查糖尿病视网膜病变的敏感性和特异性

The sensitivity and specificity of one field non-mydriatic digital fundus photography for DR screening

目的:单视野免散瞳眼底照相和散瞳直接眼底镜检查与荧光素眼底血管造影(fundus fluorescein angiography,FFA)相比较,评价其筛查糖尿病视网膜病变(diabetic retinopathy,DR)的敏感性和特异性。方法:1型或2型糖尿病患者93例186眼,先后进行单视野免散瞳数码眼底照相、散瞳直接眼底镜检查和FFA,以FFA诊断结果作为比较标准,评价单视野免散瞳数码眼底照相和散瞳直接眼底镜筛查DR的敏感性和特异性。结果:单视野免散瞳数码眼底照相检出DR的敏感性和特异性分别为80.4%和94.7%,而散瞳直接眼底镜检出DR的敏感性和特异性分别为64.2%和84.2%。当把筛查阈值下调至中度非增殖性DR(M-NPDR)后,单视野免散瞳数码眼底照相检出DR的敏感性和特异性分别提高为88.9%和98.4%,散瞳直接眼底镜检出DR的敏感性和特异性也均有提高,分别为71.5%和96.7%。结论:单视野免散瞳数码眼底照相是筛查DR的有效工具。

AIM：To evaluate the sensitivity and specificity of one- field non-mydriatic digital fundus photography and direct ophthalmoscopy for diabetic retinopathy DR） screening, compared with fundus fluorescein angiography（ FFA ）. METHODS： All 93 patients of type 1 or 2 diabetic who have underwent one-field non-mydriatic digital fundus photography, and direct ophthalmoscopy with dilation of their pupils, and FFA by ophthalmologists. The sensitivity and specificity of one-field non-mydriatic digital fundus photography and direct ophthalmoscopy were calculated respectively, compared with FFA. RESULTS： The sensitivity and specificity of one-field non-mydriatic digital fundus photography for detection of any DR were 80. 4% and 94. 7%; The sensitivity and specificity of direct ophthalmoscopy for detection of any DR were 64. 2% and 84. 2%; After the standard for referable DR being lowered down to the moderate non- proliferative diabetic retinopathy （M - NPDR ）, the sensitivity and specificity of non-mydriatic digital fundus photography for detection were 88.9% and 98.4%, the sensitivity and specificity of direct ophthalmoscopy for detection were 71.5% and 96.7%. CONCLUSION. One-field non- mydriatic digital fundus photography is an effective method for DR screening.