AIM：To detect early glaucoma by optical coherence tomography（OCT） posterior pole asymmetry analysis.METHODS：Totally 39 eyes from 39 healthy subjects,40 eyes from 40 mild glaucoma patients,33 eyes from 33 moderate ...AIM：To detect early glaucoma by optical coherence tomography（OCT） posterior pole asymmetry analysis.METHODS：Totally 39 eyes from 39 healthy subjects,40 eyes from 40 mild glaucoma patients,33 eyes from 33 moderate glaucoma patients and 41 eyes from severe glaucoma patients were included in this study.All subjects underwent posterior pole asymmetry analysis（PPAA） of OCT and the posterior pole area was divided into three zones.Means,standard deviations and 95% confidence intervals of each zone asymmetry in control group were assessed.Retina thickness asymmetry（RTA） of different stage of glaucoma were compared for each zone,and receiver operating characteristic（ROC） curves were made to test the efficacy of strategies using different zones to discriminate glaucomatous eyes from the healthy ones.RESULTS：In a healthy population,RTA of the centre zone showed the minimal mean value（3.085 μm）,standard deviation（1.756）,and the narrowest 95% confidence interval（from 2.360 to 3.810 μm）.It was only in the center zone that RTA exhibited significant difference between control and moderate glaucoma group（P〈0.01）,as well as control and severe glaucoma group（P〈0.00001）.The strategy utilized in the center zone had the strongest diagnostic capability（zone 3 AUROC=0.816,P=0.0016） in comparison to that of the periphery area（zone 1 AUROC=0.675,P=0.0016;zone 2 AUROC=0.623,P=0.0197）,the whole posterior pole involved interpreting strategy showed inferior diagnostic power than the centre zone dependent strategy（z=2.851,P=0.0044）.CONCLUSION：Utilizing the posterior pole centre zone to interpret OCT PPAA results are more effective than making use of the whole posterior pole map.展开更多
AIM:To explore the influencing factors of diabetes type 2 patients with mild non-proliferative diabetic retinopathy(NPDR)in the Kailuan area of Tangshan,Hebei Province,China.METHODS:In this non-interventional,retrospe...AIM:To explore the influencing factors of diabetes type 2 patients with mild non-proliferative diabetic retinopathy(NPDR)in the Kailuan area of Tangshan,Hebei Province,China.METHODS:In this non-interventional,retrospective study,683 patients with type 2 diabetes were included in the Kailuan Diabetic Retinopathy Study involving participants with diabetes in the community-based longitudinal Kailuan Study.Based on the undilated ultrawide field(200°;UWF)images and partial dilated digital fundus images,the diabetic retinopathy(DR)of the surveyed population was graded.Interobserver agreement was estimated by using Cohen’s Kappa statistics.The main outcome indicators included gender,age,weight,height,body mass index,blood pressure,circumferences of neck,waist and hip,current smoking,levels of fasting plasma glucose(FPG),hypersensitive C-reactive protein,creatinine,and cholesterol,etc.According to different lesions’locations of patients with mild NPDR,logistic regression models were used to estimate the odds ratios(ORs)and their 95%Cls of each risk factor.RESULTS:The study group of 683 patients included 570 males and 113 females.The mean age of the patients was62.18±9.41 y.Compared with dilated fundus examinations,there was fair agreement with the level of DR identified on UWF images in 63.91%of eyes(k=0.369,95%CI,0.00-0.00).Detected by UWF images,there were 98 patients with mild NPDR having peripheral retinal lesions,35 patients with mild NPDR having posterior lesions,44 patients with mild NPDR whose lesions were detected both in and out the standard two fields area,and 336 patients with non obvious DR.Parameters that conferred a statistically significant increased risks for mild NPDR with having peripheral retinal lesions were neck circumstance(OR,1.124;95%CI,1.044-1.211),and with posterior lesions were FPG(OR,1.052;95%CI,1.007-1.099).CONCLUSION:UWF is an effectiveness means of DR screening.Moreover,it is necessary to evaluate peripheral diabetic retinal lesions which can help to estimate the severity of DR.The phenomenon that nonuniform and inhomogeneous distribution of DR lesions has been found.And the influencing factors in mild NPDR are differing by different lesions’locations.展开更多
基金Supported by National Natural Science Foundation of China(No.81270993)National Major Scientific Equipment Program(No.2012YQ12008005)the Specialized Research Fund for the Doctoral Program of Higher Education(No.20130181110079)
文摘AIM：To detect early glaucoma by optical coherence tomography（OCT） posterior pole asymmetry analysis.METHODS：Totally 39 eyes from 39 healthy subjects,40 eyes from 40 mild glaucoma patients,33 eyes from 33 moderate glaucoma patients and 41 eyes from severe glaucoma patients were included in this study.All subjects underwent posterior pole asymmetry analysis（PPAA） of OCT and the posterior pole area was divided into three zones.Means,standard deviations and 95% confidence intervals of each zone asymmetry in control group were assessed.Retina thickness asymmetry（RTA） of different stage of glaucoma were compared for each zone,and receiver operating characteristic（ROC） curves were made to test the efficacy of strategies using different zones to discriminate glaucomatous eyes from the healthy ones.RESULTS：In a healthy population,RTA of the centre zone showed the minimal mean value（3.085 μm）,standard deviation（1.756）,and the narrowest 95% confidence interval（from 2.360 to 3.810 μm）.It was only in the center zone that RTA exhibited significant difference between control and moderate glaucoma group（P〈0.01）,as well as control and severe glaucoma group（P〈0.00001）.The strategy utilized in the center zone had the strongest diagnostic capability（zone 3 AUROC=0.816,P=0.0016） in comparison to that of the periphery area（zone 1 AUROC=0.675,P=0.0016;zone 2 AUROC=0.623,P=0.0197）,the whole posterior pole involved interpreting strategy showed inferior diagnostic power than the centre zone dependent strategy（z=2.851,P=0.0044）.CONCLUSION：Utilizing the posterior pole centre zone to interpret OCT PPAA results are more effective than making use of the whole posterior pole map.
文摘AIM:To explore the influencing factors of diabetes type 2 patients with mild non-proliferative diabetic retinopathy(NPDR)in the Kailuan area of Tangshan,Hebei Province,China.METHODS:In this non-interventional,retrospective study,683 patients with type 2 diabetes were included in the Kailuan Diabetic Retinopathy Study involving participants with diabetes in the community-based longitudinal Kailuan Study.Based on the undilated ultrawide field(200°;UWF)images and partial dilated digital fundus images,the diabetic retinopathy(DR)of the surveyed population was graded.Interobserver agreement was estimated by using Cohen’s Kappa statistics.The main outcome indicators included gender,age,weight,height,body mass index,blood pressure,circumferences of neck,waist and hip,current smoking,levels of fasting plasma glucose(FPG),hypersensitive C-reactive protein,creatinine,and cholesterol,etc.According to different lesions’locations of patients with mild NPDR,logistic regression models were used to estimate the odds ratios(ORs)and their 95%Cls of each risk factor.RESULTS:The study group of 683 patients included 570 males and 113 females.The mean age of the patients was62.18±9.41 y.Compared with dilated fundus examinations,there was fair agreement with the level of DR identified on UWF images in 63.91%of eyes(k=0.369,95%CI,0.00-0.00).Detected by UWF images,there were 98 patients with mild NPDR having peripheral retinal lesions,35 patients with mild NPDR having posterior lesions,44 patients with mild NPDR whose lesions were detected both in and out the standard two fields area,and 336 patients with non obvious DR.Parameters that conferred a statistically significant increased risks for mild NPDR with having peripheral retinal lesions were neck circumstance(OR,1.124;95%CI,1.044-1.211),and with posterior lesions were FPG(OR,1.052;95%CI,1.007-1.099).CONCLUSION:UWF is an effectiveness means of DR screening.Moreover,it is necessary to evaluate peripheral diabetic retinal lesions which can help to estimate the severity of DR.The phenomenon that nonuniform and inhomogeneous distribution of DR lesions has been found.And the influencing factors in mild NPDR are differing by different lesions’locations.
