摘要
目的探讨超广角荧光素眼底血管造影检查(UWFA)在识别糖尿病视网膜病变(DR)新生血管及黄斑水肿中的应用。方法回顾性病例研究。选取2020年6月至2022年3月收治于我院的102例(184只眼)DR患者作为研究对象,平均年龄(55.63±2.39)岁,平均病程(5.13±1.39)年。所有患者均进行UWFA和标准7视野(7SF)检查,分为UWFA组和7SF组;分别对比两种检测方法的观察范围、视网膜病变检出及分期情况、5种DR眼底病变检出情况、黄斑水肿的检查结果;通过受试者工作特征(ROC)曲线分析UWFA与7SF及二者联合检测DR的效能。结果UWFA在视网膜NP区面积、视网膜可视区面积、全视网膜激光光凝区面积、视网膜新生血管(NV)区面积方面均高于7SF,而取图平均时间则显著低于7SF(P<0.05);UWFA对DR病情程度检出准确率为95.11%(175/184),高于7SF的88.59%(163/184),差异具有统计学意义(P<0.05);UWFA对五种DR眼底病变(视网膜新生血管、微血管瘤、无灌注区、黄斑水肿、黄斑区拱环结构改变)检出率均高于7SF(均P<0.05);UWFA对局灶性黄斑水肿、弥漫性黄斑水肿、黄斑缺血的检出率均高于7SF(均P<0.05);UWFA检测的ROC曲线下面积、阳性预测值、阴性预测值、灵敏度、特异度均高于7SF,具有更优的诊断效能,且二者联合检测(串联)的ROC曲线下面积、阳性预测值、阴性预测值、特异度均优于单独检测。结论利用UWFA实现了基于新生血管及黄斑水肿的DR分级,且UWFA的准确度以及精度均高于7SF,在临床试验中能够较为可靠地识别糖尿病视网膜病变。
Objective To explore the application of ultra-wide-angle fluorescein fundus angiography(UWFA)in the identification of diabetic retinopathy(DR)neovascular and macular oedema.Methods A retrospective case series study.102 patients(184 eyes)with DR admitted to our hospital from June 2020 to March 2022 were selected,with an average age of(55.63±2.39)years and an average course of(5.13±1.39)years.All patients underwent UWFA and standard 7 visual field(7SF)examinations,and were divided into UWFA group and 7SF group.The observation range of the two detection methods,the detection and staging of retinopathy,the detection of 5 DR fundus lesions,and the examination results of macular oedema were compared and analysed.Through the subjects'work special the eigen(ROC)curve analyses the efficiency of UWFA and 7SF and the combination of DR detection.Results UWFA was significantly higher than 7SF in terms of retinal nonperfusion(NP)area,retinal visual area,retinal laser photocoagulation area and retinal neovascularization(NV)area area,while the average time was significantly lower than 7SF(P<0.05).UWFA detection accuracy of disease degree was 95.11%(175/184),significantly higher than 88.59%(163/184)of 7SF,with significant difference(P<0.05).UWFA for five DR fundus lesions(retinal neovascularisation,micro haemangioma,no perfusion area,macular oedema,macular arch ring junction)The detection rate of structural change is significantly higher than 7SF(P<0.05).The detection rate of focal macular oedema,diffuse macular oedema and macular ischaemia by UWFA is significantly higher than 7SF(P<0.05).The area under the ROC curve,positive prediction value,negative prediction value,Ling The sensitivity and specificity are significantly higher than 7SF,which has better diagnostic efficiency,and the combined detection effect of the two is better than that of individual detection.Conclusions UWFA is used to achieve DR classification based on neovascular and macular oedema,and the accuracy and accuracy of UWFA are higher than 7SF,which can reliably identify diabetic retinopathy in clinical trials.
作者
曾令娟
秦维灿
唐德友
Zeng Lingjuan;Qin Weican;Tang Deyou(Department of Ophthalmology,the Second People's Hospital of Deyang City,Deyang 618000,China)
出处
《临床眼科杂志》
2023年第6期508-513,共6页
Journal of Clinical Ophthalmology
