摘要
目的探讨蔡司第3代及第4代光学相干断层成像(OCT)和海德堡视网膜断层扫描(HRT-Ⅱ)检测糖尿病黄斑水肿(DME)的可行性。方法采用Cirrus OCT、Stratas OCT和HRT-Ⅱ对41只糖尿病视网膜病变(DR)患眼及24只正常对照眼进行黄斑容积512×128组合扫描(Cirrus OCT)、快速黄斑地形图扫描(Stratas OCT)、线性扫描(Stratas OCT)和HRT-Ⅱ检查。结果以上述4种检测方式的正常对照组95%可信区间上限分界值判断DR组患眼是否存在DME,4种检测方式的灵敏度依次为73.68%、36.84%、73.68%、73.68%,特异度依次为100.00%、100.00%、90.91%、36.36%。以荧光素眼底血管造影及眼底检查结果为"金标准",绘制上述4种检测方法的接受者操作特性曲线(ROC曲线),其ROC曲线面积依次为0.937、0.935、0.908、0.554,以ROC曲线最佳界值判断DR组患眼是否存在DME,此时其灵敏度依次为89.47%、89.47%、89.47%、36.84%,特异度依次为81.82%、81.82%、81.82%、90.91%。结论 Cirrus OCT、Stratas OCT和HRT-Ⅱ均能够量化测量DME。两种OCT能比较客观地评价DME,且在量化评价DME时,两代OCT的价值相差不大。HRT-Ⅱ检测DME仅能顾及灵敏度和特异度之一,其量化评价DME时的临床价值要劣于第3代及第4代OCT。
Objective To discuss the feasibility of Cirrus optical coherence tomography（OCT）,Stratas OCT and Heidelberg retinal tomography（HRT-Ⅱ） in detecting diabetic macular edema（DME）.Methods Forty-one eyes in 21 patients with diabetic retinopathy and 24 eyes in 12 normal volunteers were examined by Cirrus OCT（macular cube 512 × 128）,Stratas OCT（fast macular thickness map and line） and HRT-Ⅱ.Results The sensitivities of macular cube 512 × 128,fast macular thickness map and line,HRT-Ⅱ were 73.68 %,36.84 %,73.68 %,73.68 %,respectively when took the 95 %-up-limiter of the normal eyes as a dividing line to discriminate DME.And the specificities were 100.00 %,100.00 %,90.91 %,36.36 %,respectively.Then discriminated DME by the receiver operating characteristic（ROC） curve,and found outthe bestpointto discriminate DME.The sensitivities and specificities were 89.47 %,89.47 %,89.47 %,36.84 % and 81.82 %,81.82 %,81.82 %,90.91 %,respectively.Conclusion Cirrus OCT,Stratas OCT and HRT-Ⅱ can assess DME quantitatively.The two kinds of OCT can assess DME objectively when HRT-Ⅱ can not get high sensitivity and specificity coinstantaneously.
出处
《生物医学工程与临床》
CAS
2010年第5期419-423,共5页
Biomedical Engineering and Clinical Medicine
基金
北京市科委科技新星项目(2005-B-043)
北京市优秀人才培养专项经费(20042D0300102)
