第三代广角数码视网膜成像系统在视网膜母细胞瘤检查诊断中的应用价值  

Application value of RetCam Ⅲ in the diagnosis of retinoblastoma

作　　者：薛康[1] 钱江[1] 岳晗[1] 任慧[1] 郭洁[1] 

机构地区：[1]复旦大学附属眼耳鼻喉科医院眼科,上海200031

出　　处：《中华眼底病杂志》2015年第4期352-354,共3页Chinese Journal of Ocular Fundus Diseases

基　　金：上海市自然科学基金（12ZR1404900）;上海市卫生局青年基金（20144Y0263）

摘　　要：目的：观察第三代广角数码视网膜成像系统（RetCam Ⅲ）在视网膜母细胞瘤（RB）检查诊断中的应用价值。方法回顾性研究。2012年1月至2014年5月临床确诊为 RB 的94例患者125只眼纳入研究。所有患者均行 RetCam Ⅲ、双目间接检眼镜及 B 型超声检查。以双目间接检眼镜检查结果作为“金标准”,对比分析 RetCam Ⅲ和双目间接检眼镜检查结对 RB 分期的一致性以及 RetCam Ⅲ、双目间接检眼镜及 B 型超声检查对 A^D 期不同分期瘤体的检出率。结果双目间接检眼镜检查发现,125只眼中,A 期18只眼,占14.4%；B 期15只眼,占12.0%；C 期10只眼,占8.0%；D 期28只眼,占22.4%；E 期54只眼,占43.2%。RetCam Ⅲ检查发现,125只眼中,A 期18只眼,占14.4%；B 期16只眼,占12.8%；C 期11只眼,占8.8%；D 期27只眼,占21.6%；E 期53只眼,占42.4%。Kappa 系数检验分析结果显示, RetCam Ⅲ与双目间接检眼镜检查结果在 RB 分期中一致性良好（加权 Kappa 系数=0.9798,95%可信区间为0.9601~0.9995）。双目间接检眼镜检查发现,125只患眼中,A ~ D 期共71只眼150个瘤体。RetCam Ⅲ检查检出瘤体数为147个,检出率为98.0%。未检出的3个瘤体均位于周边接近锯齿缘视网膜处。B 型超声检查检出瘤体数为122个,检出率为81.3%。RetCam Ⅲ检查过程中,未见角膜挫伤、玻璃体积血、视网膜出血、呼吸暂停、心跳骤停等局部或全身并发症发生。结论RetCam Ⅲ可有效检出各种分期的 RB,与双目间接检眼镜检查结果的一致性良好。Objective To observe the application value of RetCam Ⅲ in the diagnosis of retinoblastoma （RB）.Methods The clinical data of 125 eyes from 94 patients with RB were retrospectively analyzed.According to the International Intraocular Retinoblastoma Classification,the results of binocular indirect ophthalmoscope and RetCam Ⅲ was compared.The consistency between RetCam Ⅲ and binocular indirect ophthalmoscope was analyzed by Kappa test.The detectable rates of tumor between binocular indirect ophthalmoscope,RetCam Ⅲ and B scan ultrasound were comparatively analyzed.Results By binocular indirect ophthalmoscope,there were 18 eyes （14.4%）in stage A,1 5 eyes （12.0%）in stage B, 10 eyes （8.0%）in stage C,28 eyes （22.4%）in stage D,and 54 eyes （43.2%）in stage E.Using RetCam Ⅲ,the classification was 18 eyes （14.4%）in stage A,1 6 eyes （12.8%）in stage B,1 1 eyes （8.8%）in stage C,27 eyes （21.6%）in stage D,and 53 eyes （42.4%）in stage E.The RB classification of RetCam Ⅲ was quite consistent with binocular indirect ophthalmoscope （Weighted Kappa Coefficient =0.979 8,95% confidence interval = 0.960 1 - 0.999 5）.A total of 1 50 tumors from stage A - D were observed by binocular indirect ophthalmoscope.In which,147 tumors （98.0%）were found by RetCam Ⅲ, 122 tumors （81.3%） were found by B scan ultrasound.No serious complication was found in these patients.Conclusions RetCam Ⅲ can detect RB of different stage in clinic.It is quite consistent with binocular indirect ophthalmoscope.

关 键 词：视网膜母细胞瘤/诊断 检眼镜检查 超声检查 

分 类 号：R739.72[医药卫生—肿瘤]