基于智能手机的非接触眼底成像筛查糖尿病视网膜病变  

Smartphone-based noncontact fundus imaging for diabetic retinopathy screening

作　　者：曾依云 董文韬[1] 邓铂林[1] ZENG Yiyun;DONG Wentao;DENG Bolin(Department of Ophthalmology,Sichuan Provincial People′s Hospital,Sichuan Academy of Medical Sciences,Chengdu 610072,China)

机构地区：[1]四川省医学科学院·四川省人民医院眼科,成都610072

出　　处：《实用医学杂志》2022年第4期464-467,共4页The Journal of Practical Medicine

基　　金：四川省科技计划项目(编号:2022YFS0234);四川省人民医院青年科研基金(编号:2017QN02);电子科技大学中央高校基金(编号:2672018ZYGX2018J098)。

摘　　要：目的评价使用基于智能手机非接触眼底成像技术在城市基层医疗机构筛查糖尿病视网膜病变(DR)的敏感性和特异性。方法2021年4月1日至2021年6月31日于四川省成都市新津区人民医院招募确诊糖尿病的患者,分别使用智能手机非接触眼底成像技术及双目间接检眼镜进行散瞳后的眼底检查并做出诊断。以双目间接检眼镜的检查结果为参考标准,评估使用智能手机非接触眼底成像技术筛查DR的敏感性和特异性。结果共纳入糖尿病患者143例276眼。以间接检眼镜的诊断结果为标准,使用智能手机非接触眼底成像技术诊断DR的总敏感性和特异性分别为84.1%和94.2%(Kappa=0.79):对轻、中度非增殖性糖尿病视网膜病变(NPDR)敏感性和特异性分别为79.2%和94.9%(Kappa=0.73);威胁视力的DR敏感性和特异性均为100%(Kappa=1)。结论基于智能手机的非接触眼底成像技术是筛查糖尿病视网膜病变的有效方法,具有较高的敏感性和特异性。作为常规DR筛查的低成本替代方法,有助于在医疗资源相对落后的地区提高DR筛查的覆盖率。Objective To evaluate the sensitivity and specificity of noncontact fundus imaging based on smartphone for diabetic retinopathy(DR)screening in urban primary medical institution.Methods We conducted a prospective and comparative study.Participants with diabetes were recruited to conduct fundus screening by smartphone-based noncontact fundus imaging and binocular indirect ophthalmoscope(BIO)after mydriasis from April 1,2021,to June 31st in People′s Hospital of Xinjin District of Chengdu.With the results of BIO as a reference standard,the sensitivity and specificity of smartphone-based noncontact fundus imaging to screen DR were evaluated.Results A total of 143 patients of 276 eyes were recruited.Based on the diagnostic result of BIO,the overall sensitivity and specificity of smartphone noncontact fundus imaging in the diagnosis of DR were 84.1%and94.2%(kappa=0.79),respectively;the sensitivity and specificity for mild/moderate NPDR were 79.2%and 94.9%(kappa=0.73),respectively;Both the sensitivity and specificity of VTDR were 100%(kappa=1).Conclusion Noncontact fundus imaging based on smartphone is an effective method for DR screening with high sensitivity and specificity.As a low-cost alternative to conventional DR screening,it may help to improve the coverage of DR screening in areas with relatively poor medical conditions.

关 键 词：糖尿病视网膜病变 筛查 智能手机 双目间接检眼镜 

分 类 号：R774.1[医药卫生—眼科]