糖尿病视网膜病变早期视功能的临床评价方法

Clinical Evaluation of Early Visual Function in Diabetic Retinopathy

目的筛选糖尿病视网膜病变早期视功能临床评价的有效方法。方法将首次就诊患2型糖尿病者(67例,100眼)。所有患者进行裸眼视力和矫正视力检查、眼前段裂隙灯显微镜检查、非接触眼压计测量眼压、45°单视野免散瞳数码眼底照相、散瞳直接检眼镜检查、眼底荧光血管造影(FFA)、光学相干断层扫描(OCT)检查。FFA诊断结果作为诊断糖尿病视网膜病变(DR)的参照标准,多种检测方法的结果与FFA结果进行一致性分析。结果 D1期,与FFA诊断结果比较,眼底照相的Kappa值为0.489,为中度一致性;检眼镜的Kappa值为0.103,为低度一致性;OCT检查的Kappa值为0.622,为中度一致性。D2期,与FFA诊断结果比较,眼底照相的Kappa值为0.781,为高度一致性;检眼镜的Kappa值为0.379,为低度一致性;OCT检查的Kappa值为0.483,为中度一致性。结论免散瞳眼底照相联合OCT检查可作为评估早期糖尿病性视网膜病变的有效方法。

Objective To select effective methods for clinical evaluation of early visual function in diabetic retinopathy patients. Methods Select randomly 67 cases of patients with type 2 diabetes（100 eyes） from ophthalmology outpatient of Heze Municipal Hospital and Heze Medical College Affiliated Hospital. All patients got the examnination of the naked eyesight, corrected visual acuity, anterior segment slit-lamp, non-contact intraocular pressure measurement, 45°single vision non-mydriatic fundus camera, direct mydriatic ophthalmoscope, fundus fluorescence angiography（FFA） and optical coherence tomography（OCT）. FFA was used as the gold standard for DR diagnosis and the results of various detection methods were consistent with FFA results. Results For D1 stage, compared with the results of FFA Kappa value of nonmydriatic fundus camera is 0.489 with moderate consistency; Kappa value of ophthalmoscope is 0.103 with low consistency;Kappa value of OCT examination is 0.622 with moderate consistency. For D2 stage, compared with the results of FFA Kappa value of non-mydriatic fundus camera is 0.781 with high consistency; Kappa value of ophthalmoscope is 0.379 with low consistency; Kappa value of OCT examination is 0.483 with moderate consistency. Conclusion Combination of non-mydriatic fundus camera and OCT can be used as an effective method to evaluate early diabetic retinopathy.