共聚焦激光扫描检眼镜与眼底彩色照相对息肉样脉络膜血管病变中视网膜色素上皮脱离的检出比较

Diagnostic performance of confocal scanning laser ophthalmoscope imaging and compared with color fundus camera in retinal pigment epithelial detachment of polypoidal choroidal vasculopathy

目的观察共聚焦激光扫描检眼镜(cSLO)和眼底彩色照相对息肉样脉络膜血管病变(PCV)中RPE脱离(PED)的检出情况。方法2016年6月至2017年6月在北京同仁医院眼科临床确诊为PCV的30例患者32只眼纳入研究。其中,男性16例17只眼,女性14例15只眼;年龄50~83岁,平均年龄66.59岁。所有患眼均行视力、眼压、裂隙灯显微镜、散瞳眼底、眼底彩色照相、cSLO、高分辨率OCT以及FFA联合ICGA检査。以多模式成像结果为金标准,计算眼底彩色照相和cSLO对浆液性和出血性PED检出的灵敏度和特异性。对比观察眼底彩色照相和cSLO成像中的PED (浆液性和出血性)检出数.并采用忙检验进行统计比较。结果经多模式成像综合判断,32只眼中,浆液性PED 20只眼,出血性PED3只眼,浆液性合并出血性PED 9只眼。以多模式成像结果为金标准,眼底彩色照相对浆液性PED检出的灵敏度、特异性分别为45%、100%.对出血性PED检出的灵敏度、特异性分别为100%、91%;cSLO对浆液性PED检出的灵敏度、特异性分别为83%、100%,对出血性PED检出的灵敏度、特异性分别为50%、86%。cSLO成像对浆液性PED的检出数显著高于眼底彩色照相,差异有统计学意义(χ^2=7.752, P=0.011 );cSLO成像对出血性PED的检出数与眼底彩色照相比较,差异无统计学意义(χ^2=1.164,P=0.419)。结论与眼底彩色照相比较,cSLO对于PCV中浆液性PED检出率更高,灵敏度更好。

Objective To observe confocal scanning laser ophthalmoscope (cSLO) based retinal imaging and color fundus camera in pigment epithelial detachment (PED) of polypoidal choroidal vasculopathy (PCV). Methods PED of 30 patients (32 eyes) were recruited from June 2016 to June 2017 in the Beijing Tongren Hospital who were detected in high-definition OCT (HD-OCT) and diagnosed as PCV by FFA and ICGA. There were 16 males (17 eyes) and 14 females (15 eyes);aged from 50?83 years, with the mean age of 66.59 years. The photographs of ocular fundus including color fundus camera, cSLO imaging, HD-OCT, FFA and ICGA were analyzed. Multimodal imaging results were regarded as gold standard. Sensitivity and specificity were calculated in serous and hemorrhagic PED diagnosis using color fundus camera and cSLO imaging. The positive number of PED was used to compare between two modes fundus imaging by using χ^2 test. Results Twenty serous PED eyes, 3 hemorrhagic PED eyes and 9 serous/hemorrhagic PED eyes were determined using multimodal imaging. The sensitivity and specificity of color fundus camera were 45% and 100% in detecting serous PED and 100% and 91% in detecting hemorrhagic PED. The sensitivity and specificity of cSLO imaging were 83% and 100% in detecting serous PED and 50% and 86% in detecting hemorrhagic PED. The positive number of serous PED in cSLO imaging was significantly higher than color fundus camera (χ^2=7.752, P=0.011). The positive number of hemorrhagic PED in cSLO imaging shows no obvious difference compared with color fundus camera (χ^2=1.164,P=0.419). Conclusion The sensitivity and positive number of detecting serous PED with PCV in cSLO fundus imaging were higher than the color fundus camera technology.