应用眼底视网膜成像系统RetcamⅢ早期诊断新生儿视网膜母细胞瘤的临床研究  

Clinical Study of Retcam Ⅲ in the Diagnosis of Neonatal Retinoblastoma by Retinal Imaging System

作　　者：但艳苹 陈清冉 饶丽[1] 

机构地区：[1]湖北省十堰市妇幼保健院儿童保健中心,湖北十堰442000

出　　处：《河北医学》2018年第2期305-309,共5页Hebei Medicine

基　　金：湖北省十堰市科学技术研究与开发计划项目;(编号:15Y70)

摘　　要：目的:分析应用眼底视网膜成像系统RetcamⅢ早期诊断新生儿视网膜母细胞瘤的临床研究价值。方法:回顾性分析2014年7月至2016年7月来我院眼科进行就诊RB新生儿患者75例,患眼100例。以上患者分别采用双目间接检眼镜、RetCamⅢ及B型超声诊断RB情况。结果:100只患眼中,通过以双目检眼镜为金标准诊断出A^E期的患眼情况,采用RetCamⅢ诊断在A期是一致的,B期、C期、D期与E期间存在较小的差别,但非常接近(P>0.05)。通过Kappa系数分析,以上2种对RB分期一致性较好,其中,Kappa系数=0.9794,95%可信区间为0.9598~0.9991。100只患眼中,A^D期有58只患眼,采用双目检眼镜共检出瘤体132个为标准,采用RetCamⅢ检出瘤体130个,检出率为98.48%,比较接近双目检眼镜金标准。B型超声检出瘤体111个,检出率为84.09%(P<0.05)。RetCamⅢ检测在结膜下出血发生2例,发生率为2.00%,而在角膜挫伤、视网膜出血、感染等方面无不良反应,总体不良率为2.00%,而双目检眼镜及B型超声在以上并发症方面不良率均较高,对比无差异(P>0.05),这揭示Ret CamⅢ诊断安全、可靠、预后良好,值得临床推广。结论:应用眼底视网膜成像系统RetcamⅢ早期诊断新生儿视网膜母细胞瘤,可以及时准确诊断瘤体分期及病情,具有较高的特异性及检出率,在临床有较高的诊断价值。Objective： To analyze the clinical value of Retcam Ⅲ in the early diagnosis of neonatal retinoblastoma using retinal imaging system. Methods： A retrospective analysis was carried out from July 2014 to July 2016 in 75 cases of RB newborns in our department of Ophthalmology and 100 cases of eyes. These patients were treated with binocular indirect ophthalmoscope,RetCam Ⅲ and B type ultrasonic diagnosis RB.Results： 100 eyes were diagnosed with a double eye ophthalmoscope for the gold standard to diagnose the AE phase of the eye condition,the use of RetCam Ⅲ diagnosis in the A phase is consistent,B,C,D and E there was a small difference,but very close（P 〉 0.05）. Through the analysis of the Kappa coefficient,the 2 kinds of RB staging are consistent,of which the Kappa coefficient was = 0.9794,and the 95% confidence interval was 0.9598-0.9991. In 100 eyes,there were 58 eyes in the A-D period. Using binocular ophthalmoscope 132 standard tumor were detected by RetCam,Ⅲ in the detection of tumor 130,the detection rate was 98.48%.111 tumor bodies were detected by B type ultrasound,and the detection rate was 84.09%（P 〈0.05）. RetCam Ⅲ detection occurred in 2 cases of subconjunctival hemorrhage,the incidence rate was 2%,but there was no adverse reaction in corneal contusion,retinal hemorrhage and infection. The overall bad rate was 2%. The binocular ophthalmoscope and B ultrasonic in the above adverse complications were higher,no difference（P 〉0.05）. This reveals that RetCam Ⅲ is safe,reliable,and has good prognosis,and is worthy of clinical application. Conclusion： The early diagnosis of neonatal retinoblastoma by Retcam Ⅲ（retina imaging system） can be used to diagnose the tumor staging and disease in a timely and accurate way. It has high specificity and detection rate,and has high diagnostic value in clinical.

关 键 词：RetcamⅢ 视网膜母细胞瘤 新生儿 早期诊断 

分 类 号：R739.7[医药卫生—肿瘤]