本文關(guān)鍵詞：全景激光掃描眼底照相在糖尿病視網(wǎng)膜病變篩查中的作用　出處：《安徽醫(yī)科大學》2014年碩士論文　論文類型：學位論文

  更多相關(guān)文章： 糖尿病視網(wǎng)膜病變篩查 全景激光掃描眼底照相

【摘要】：目的：探討全景激光掃描眼底照相(Optomap)作為篩查糖尿病視網(wǎng)膜病變(diabetic retinopathy,DR)方法的可行性。 方法：前瞻性臨床病例研究,研究對象為經(jīng)我院糖尿病中心確診的1型和2型糖尿病并參加視網(wǎng)膜病變篩查的患者,共75例患者,141只眼。所有的病例均進行全景激光掃描免散瞳眼底照相和七方位散瞳眼底照相,觀察各種糖尿病視網(wǎng)膜病變眼底陽性表現(xiàn)敏感性,特異性。以糖尿病視網(wǎng)膜病變國際分期及國內(nèi)分期為標準比較全景激光掃描眼底照相篩查糖尿病視網(wǎng)膜病變的敏感性,特異性,以及與七方位眼底照相檢查的一致性。以黃斑出血和滲出性病變?yōu)橹笜嗽u價全景激光掃描眼底照相篩查糖尿病性黃斑病變的敏感性和特異性。 結(jié)果：各種糖尿病視網(wǎng)膜病變眼底陽性表現(xiàn)敏感性,特異性以及與七方位散瞳眼底照相一致性如下：微血管瘤的敏感性為51.2%,特異性為48.3%,一致性為k=0.536,視網(wǎng)膜出血的敏感性為91.8%,特異性為95.6%,一致性為k=0.901,硬性滲出的敏感性為85.3%,特異性為87.9%,一致性為k=0.864,棉絨斑的敏感性為85.7%,特異性為87.5%,一致性為k=0.852,新生血管的敏感性為72.1%,特異性為76.9%,一致性為k=0.745,玻璃體積血的敏感性為64.2%,特異性為70.0%,一致性為k=0.658,微血管異常的敏感性為43.0%,特異性為46.5%,一致性為k=0.456,靜脈串珠的敏感性為47.7%,特異性為49.8%,一致性為k=0.485。以國際糖尿病視網(wǎng)膜病變分期為標準,以輕度非增殖性糖尿病視網(wǎng)膜病變?yōu)殚撝禃r,全景激光掃描眼底照相診斷的敏感性為73.45%,特異性為75.01%,陽性預(yù)測值為0.772,陰性預(yù)測值為0.738,一致性為0.625。以中度非增殖性糖尿病視網(wǎng)膜病變?yōu)殚撝?全景激光掃描眼底照相的敏感性為94.85%,特異性為98.82%,陽性預(yù)測值為0.865,陰性預(yù)測值為0.905,一致性為0.912。以重度非增殖性糖尿病視網(wǎng)膜病變?yōu)殚撝?全景激光掃描眼底照相的敏感性為70.65%,特異性為79.78%,陽性預(yù)測值為0.714,陰性預(yù)測值為0.730,一致性為0.772。以糖尿病視網(wǎng)膜病變國內(nèi)分期為標準時,全景激光掃描眼底照相診斷Ⅰ期糖尿病視網(wǎng)膜病變的敏感性為51.2%,特異性為48.3%,一致性為k=0.536；Ⅱ期病變的敏感性為91.8%,特異性為95.6%,一致性為k=0.901,Ⅲ期及以上病變的敏感性為69.5%,特異性為72.8%,一致性為71.5%。全景激光掃描眼底照相篩查黃斑區(qū)出血和黃斑滲出性病變的敏感性和特異性分別為0.782,0.875和0.754,0.862。 結(jié)論：全景激光掃描眼底照相對中度NPDR以上的糖尿病視網(wǎng)膜病變及黃斑病變具有良好的敏感性和特異性,可作為一種門診免散瞳眼底照相篩查糖尿病視網(wǎng)膜病變的可靠方法。
[Abstract]:Objective: to investigate the feasibility of panoramic laser scanning fundus photography (Optomapa) as a screening method for diabetic retinopathy (DM). Methods: a prospective clinical study of 75 patients with type 1 and type 2 diabetes mellitus and retinopathy screening was carried out in our hospital. 141 eyes. All the patients underwent panoramic laser scanning without pupil radiography and seven directions pupil fundus radiography to observe the sensitivity of all kinds of diabetic retinopathy fundus positive. To compare the sensitivity and specificity of panoramic laser scanning fundus photography in screening diabetic retinopathy according to the international and domestic stages of diabetic retinopathy. The sensitivity and specificity of panoramic laser scanning fundus photography for the screening of diabetic macular lesions were evaluated with macular hemorrhage and exudative lesions. Results: the sensitivity, specificity and consistency with the radiography of the eye fundus of all kinds of diabetic retinopathy were as follows: the sensitivity of microangioma was 51.2 and the specificity was 48.3%. The consistency was 0.536, the sensitivity of retinal hemorrhage was 91.8, the specificity was 95.60.901, the sensitivity of rigid exudation was 85.3%. The specificity was 87.9, the consistency was 0.864, the sensitivity was 85.7, the specificity was 87.5, and the consistency was 0.852. The sensitivity of neovascularization was 72.1%, the specificity was 76.9, the consistency was 0.745, the sensitivity of vitreous volume blood was 64.2 and the specificity was 70.0%. The consistency was 0.658, the sensitivity of microvascular abnormality was 43.0, the specificity was 46.5, the consistency was 0.456, the sensitivity of intravenous beads was 47.7%. The specificity was 49.8 and the consistency was 0.485.When the international stage of diabetic retinopathy was taken as the standard and the threshold value was mild nonproliferative diabetic retinopathy. The sensitivity, specificity, positive predictive value and negative predictive value of panoramic laser scanning fundus photography were 73.45, 75.01, 0.772 and 0.738, respectively. The consistency was 0.625.The sensitivity of panoramic laser scanning was 94.85 and the specificity was 98.82% with moderate nonproliferative diabetic retinopathy as the threshold. The positive predictive value was 0.865, the negative predictive value was 0.905, the consistency was 0.912. The threshold value was severe non-proliferative diabetic retinopathy. The sensitivity, specificity, positive predictive value and negative predictive value of panoramic laser scanning fundus photography were 70.65, 79.78, 0.714 and 0.730, respectively. The consistency was 0.772.The sensitivity of panoramic laser scanning fundus photography for the diagnosis of stage I diabetic retinopathy was 51.2% when the domestic stage of diabetic retinopathy was taken as the standard. The specificity was 48.3 and the consistency was 0.536; The sensitivity of stage 鈪，

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