超广角眼底照相在孔源性视网膜脱离患者术前检查的临床应用

Clinical application of the ultra-widefield laser ophthalmoscope to the preoperative examination of patients with rhegmatogenous retinal detachment

目的对比分析欧堡Daytona 200度超广角激光扫描检眼镜和三面镜在孔源性视网膜脱离术前的结果,评估两种检查方法的一致性并分析相关影响因素。方法回顾性分析行玻璃体切除术的孔源性视网膜脱离患者共111例(111眼),术前均进行自然瞳孔下欧堡Daytona 200度超广角激光扫描眼底检查和散瞳后三面镜检查,记录术中和术前检查结果并进行比较分析。结果两种检查方法裂孔检出率的Kappa值为0.447,一致性中等。两种检查方法检出不同类型的视网膜裂孔的数量存在差异。其中差异最大的是圆孔,其他类型裂孔的遗漏相对较少。结论欧堡200度超广角激光扫描检眼镜在孔源性视网膜脱离的术前检查效果与三面镜检查一致性中等,可能会遗漏较周边的视网膜裂孔和黄斑裂孔,尤其是周边视网膜的圆孔。

Objective To compare the usefulness of the ultra-widefield laser ophthalmoscope(Daytona)and the three-mirror contact lens for detecting preoperative retinal breaks in a patient with rhegmatogenous retinal detachment,evaluate their consistency,and analyze their related factors.Methods One hundred and eleven eyes of patients with rhegmatogenous retinal detachment were retrospectively reviewed.Retinal images of the patients were obtained with the Optomap ultra-widefield laser ophthalmoscope imaging system and their fundi were examined with a three-mirror contact lens by ophthalmologists.All patients had undergone vitrectomy.The findings from the Optomap retinal images and the three-mirror contact lens examination were compared with the findings of the pars plana vitrectomy(PPV).Results The consistency of the two methods was moderate for detecting rhegmatogenous retinal detachment(Kappa=0.447).The number of different types of retinal holes detected by the two methods was different.The detection of the round hole demonstrated the most significant difference.Few other types of holes were missed for the two methods.Conclusion The ultra-wide-angle laser scanning ophthalmoscope fundus examination system is moderately consistent with the three-mirror contact lens for the preoperative examination of rhegmatogenous retinal detachment,and it may miss more peripheral retinal tears and macular holes,especially peripheral round retinal holes.