Daytona超广角激光扫描眼底成像与FFA在老年白内障病人糖尿病性视网膜病变筛查中的一致性分析  

Consistency between Daytona ultra-wide-field scanning laser ophthalmoscope and FFA in screening diabetic retinopathy in elderly patients with cataract

作　　者：刘戈[1] 刘洋[1] 罗杰[1] LIU Ge;LIU Yang;LUO Jie(Department of Ophthalmology,Daqing Oilfield General Hospital,Daqing 163001,China)

机构地区：[1]大庆油田总医院眼科,黑龙江省大庆市163001

出　　处：《实用老年医学》2024年第11期1148-1152,共5页Practical Geriatrics

摘　　要：目的探讨Daytona超广角激光扫描眼底成像与荧光素眼底血管造影(fundus fluorescein angiography,FFA)筛查老年白内障病人糖尿病性视网膜病变(diabetic retinopathy,DR)的一致性。方法采用横断面研究方法,选取2021年4月至2023年8月在大庆油田总医院眼科门诊就诊的年龄≥60岁合并糖尿病的老年白内障病人172例(323眼),所有病人均接受Daytona超广角激光扫描眼底成像以及FFA检查,分别记录2种检查方法诊断DR以及DR分期情况。采用卡方检验、加权Kappa一致性检验、Spearman偏回归分析对2种检查结果的相关性进行分析。结果2种检查方法的可阅片率差异无统计学意义(93.8%比94.1%,P=0.869)。Daytona超广角系统检查时间较FFA检查时间明显缩短(Z=16.85,P<0.001)。排除未得到眼底图像25眼,最终153例298眼纳入一致性研究。Daytona超广角系统与FFA检测DR分期完全一致278只眼(93.29%),Kappa值为0.925,95%CI:0.892~0.958。以FFA为金标准,Daytona超广角系统检测增生型DR的敏感度和特异度分别为90.00%、100.00%,Kappa值为0.926;检测非增生型DR的敏感度、特异度分别为94.47%、90.91%,Kappa值为0.900。Daytona超广角系统与FFA检测DR分期结果呈高度正相关(r=0.921)。结论Daytona超广角激光扫描眼底成像对合并糖尿病的老年白内障病人DR筛查效果及分期与FFA有很好的一致性。Objective To explore the consistency between Daytona ultra-wide-field scanning laser ophthalmoscope and fundus fluorescein angiography(FFA)in screening diabetic retinopathy(DR)in the elderly patients with cataract and diabetes mellitus(DM).Methods A cross-sectional study was conducted.A total of 172(323 eyes)elderly patients with cataract complicated with DM aged≥60 years old admitted to Ophthalmology Clinic of Daqing Oilfield General Hospital from April 2021 to August 2023 were enrolled in this study.Daytona ultra-wide-field scanning laser ophthalmoscope and FFA were applied to screen DR.The data were analyzed using chi-square test,weighted Kappa test and Spearman partial regression analysis.Results No significant difference was found in readability of fundus imaging betweeen Daytona ultra-wide-field scanning laser ophthalmoscope and FFA(93.8%vs.94.1%,P=0.869).The examination duration of Daytona ultra-wide-field scanning laser ophthalmoscope was 2.3(1.7,5.2)min,compared with 9.5(7.3,12.0)min of FFA(Z=16.85,P<0.001).The complete consistency rate in determining DR stage between Daytona ultra-wide-field scanning laser ophthalmoscope and FFA was 93.29%(278/298)(Kappa=0.925,95%CI:0.892-0.958).The sensitivity and specificity of Daytona ultra-wide-field scanning laser ophthalmoscope in detecting non-proliferative DR was 94.47%and 90.91%,respectively,with a Kappa value of 0.900.The sensitivity and specificity of Daytona ultra-wide-field scanning laser ophthalmoscope in detecting proliferative DR was 90.00%and 100.00%,respectively,with a Kappa value of 0.926.The results of DR stage diagnosed by Daytona ultra-wide-field scanning laser ophthalmoscope were significantly correlated with FFA(r=0.921).Conclusions There is a high consistency between Daytona ultra-wide-field scanning laser ophthalmoscope and FFA in screening and staging DR in the elderly patients with cataract and DM.

关 键 词：Daytona超广角激光扫描眼底成像 眼底荧光血管造影检查 糖尿病性视网膜病变 白内障 糖尿病 

分 类 号：R587.1[医药卫生—内分泌] R776.1[医药卫生—内科学]