眼底照相和荧光素眼底血管造影在诊断藏族糖尿病视网膜病变中的临床对比研究

A Comparative Study of Fundus Photography and Fluorescein Fundus Angiography in the Diagnosis of Diabetic Retinopathy in Tibetans

目的研究比较眼底照相(FP)和荧光素眼底血管造影(FFA)在藏族糖尿病视网膜病变(DR)中临床诊疗的应用价值。方法选取85例(170眼)通过检眼镜初诊为糖尿病视网膜病变的患者分别进行眼底照相与FFA检查,将两种方法诊断的DR分期进行分析,采用Kappa检验对比两种方法诊断的一致性。结果85例(170眼)藏族DR患者通过眼底照相诊断为轻度NPDR者50眼(29.4%),中度NPDR者52眼(30.6%),重度NPDR者60眼(35.3%),PDR者8眼(4.7%)。而通过FFA诊断为轻度NPDR者35眼(20.6%),中度NPDR者66眼(38.8%),重度NPDR者53眼(31.2%),PDR者16眼(9.4%)。眼底照相与FFA两种检查方法判断DR临床分期结果的一致性较好(K=0.733,P<0.01),一致率为81.2%。结论在藏族患者DR的诊断中,眼底照相与FFA检查对DR的分期诊断一致率较好,但眼底照相可能出现DR分期诊断的偏差,FFA检查在诊断及分期中有着更为重要的临床价值。

Objective To compare the clinical value of fundus photography( FP) and fluorescein fundus angiography( FFA) in the diagnosis and treatment of diabetic retinopathy( DR) in Tibetans.Methods A total of 85 patients( 170 eyes) with diabetic retinopathy diagnosed by ophthalmoscope were examined by fundus photography and FFA respectively.The DR stages diagnosed by the two methods were analyzed,and the consistency of the two methods was compared by Kappa test.Results Among 85 Tibetan DR patients( 170 eyes) examined by fundus photography,there were 50 eyes( 29. 4%) diagnosed as mild NPDR,52 eyes( 30. 6%) as moderate NPDR,60 eyes( 35. 3%) as severe NPDR and 8 eyes( 4. 7%) as PDR.While by the examination of FFA,35 eyes( 20. 6%) were diagnosed as mild NPDR,66 eyes( 38. 8%) as moderate NPDR,53 eyes( 31. 2%) as severe NPDR and 16 eyes( 9. 4%) as PDR.The consistency between fundus photography and FFA was good( K = 0. 733,P<0. 01),and the consistency rate was 81. 2%.Conclusion In the diagnosis of DR in Tibetan patients,the coincidence rate between fundus photography and FFA examination is fairly good,but fundus photography may lead to the deviation of DR staging diagnosis.FFA examination has more important clinical value in diagnosis and staging.