对比视盘损伤可能度、杯盘比和青光眼可能性评分诊断原发性开角型青光眼的能力  

Comparison of disc damage likelihood scale,cup to disc ratio,and glaucoma probability score for diagnosis of primary open-angle glaucoma

作　　者：崔敏[1,2] 陈晓明[1] 邓应平[1] 

机构地区：[1]四川大学华西医院眼科,四川省成都市610041 [2]成都爱尔眼科医院

出　　处：《眼科新进展》2011年第4期357-360,共4页Recent Advances in Ophthalmology

摘　　要：目的利用海德堡视网膜断层扫描仪-Ⅲ(Heidelberg retina tomography-Ⅲ,HRT-Ⅲ)对受试者进行视盘损伤可能度(disc damage likelihood scale,DDLS)分期,评价DDLS分期是否比杯盘比(cup to disc ratio,C/D)和青光眼可能性评分(glaucomaprobability score,GPS)更准确地诊断原发性开角型青光眼(primary open-angle glaucoma,POAG)。方法将POAG患者60例、可疑开角型青光眼患者31例和正常人54人纳入本研究。在双盲情况下检查眼底并确定C/D。完成对受检者的OCTOPUS-900视野计和HRT-Ⅲ检查后,分别得到视野平均缺损值和GPS值。根据受检者的HRT-Ⅲ地形图,对照DDLS评分表,对受检者的视盘进行DDLS分期。建立受试者操作特征曲线(receiver operating characteristic curve,ROC),计算DDLS分期、C/D和GPS的受试者操作特征曲线下面积,并计算最佳临界值的敏感度、特异度。结果正常组、SOAG组、POAG组的DDLS分期、C/D、GPS值逐渐增高,且两两比较差异均有统计学意义(均为P<0.01)。DDLS分期、C/D和GPS的ROC曲线下面积分别为0.932、0.874、0.960。DDLS分期的最佳临界值为5,其敏感度为93.3%,特异度为85.2%;C/D的最佳临界值为0.5,其敏感度为81.7%,特异度为77.8%;GPS的最佳临界值为0.36,其敏感度为91.7%,特异度为85.2%。结论利用HRT-Ⅲ的DDLS分期,是一种比C/D更好的诊断POAG视神经损害的方法,与GPS的诊断价值相当。Objective To evaluate whether disc damage likelihood scale（DDLS） by Heidelberg retina topography-Ⅲ（HRT-Ⅲ） is a superior method compared with cup to disc ratio（C/D） or glaucoma probability score（GPS） for diagnosis of primary open-angle glaucoma（POAG）. Methods About 60 cases with POAG,31 cases with suspected open-angle glaucoma（SOAG） and 54 normal people were enrolled in the study.The optic discs were examined independently with double-blind to determine the C/D.Mean deviation values and GPS values were obtained respectively after all eyes were detected by OCTOPUS-900 visual field perimetry and HRT-Ⅲ.Grading of the DDLS score were performed by topography of HRT-Ⅲ. Receiver operating characteristic curve（ROC） was established.We calculated the area under ROC of DDLS stage,C/D and GPS.Specificity and sensitivity of DDLS stage,C/D and GPS were calculated by ROC curves. Results DDLS stage,C/D and GPS values were gradually increased in normal group,SOAG group and POAG group.The area under ROC curve of DDLS stage,C/D and GPS was 0.932,0.874,and 0.960,respectively.The best critical value of DDLS stage,C/D and GPS were 5,0.5 and 0.36,respectively.DDLS had a sensitivity and specificity of 93.3% and 85.2%.C/D had a sensitivity and specificity of 81.7% and 77.8%.GPS had a sensitivity and specificity of 91.7% and 85.2%. Conclusion The DDLS stage by HRT-Ⅲ is superior to C/D,while it is comparable with GPS for diagnosis of POAG.

关 键 词：原发性开角型青光眼 视盘损伤可能度 杯盘比 青光眼可能性评分 

分 类 号：R775[医药卫生—眼科]