摘要
目的 评价不同观察者间和同一观察者不同时间对视乳头地形图参数分析的一致性。方法 应用海德堡视网膜断层扫描仪 (HRT)检测 14例 (2 4只眼 )正常人和 16例 (2 6只眼 )原发性开角型青光眼患者的视乳头地形图 ,再由 3位青光眼专业医师分别独立描画受检者的视乳头边界轮廓线 ,其中 1位医师于不同时间分别描画 3次。用HRT软件 (2 0 1版本 )对 11个视乳头地形图参数 (视乳头面积、视杯面积、视杯 /视盘面积、盘沿面积、视杯容积、盘沿容积、平均视杯深度、最大视杯深度、视杯形态测量、平均视网膜神经纤维厚度、视网膜神经纤维层截面面积 )进行分析 ,并分别计算类内相关系数 (ICC值 )和结果判断一致性 (kappa值 )。结果 3位不同观察者间检测患者视乳头地形图的各参数基本一致 ,ICC值为 0 976～ 0 999,kappa值为 0 6 4 9～ 0 76 7,显示三者间检测结果的一致性较好 ;同一观察者不同时间检测的视乳头地形图各参数基本一致 ,ICC值为 0 983～ 0 999,kappa值为 0 810～0 95 1,显示同一观察者不同时间检测结果的一致性较好。结论 在具有一定经验的观察者间和同一观察者不同时间 ,对HRT图像视乳头轮廓线描画的一致性均较好 ,该方法可用于青光眼的临床诊断和追踪观察。
Objective To evaluate the interobserver and intraobserver agreement of parameters of optic nerve head by Heidelberg Retina Tomograph (HRT). Methods Optic nerve heads from 50 eyes (30 subjects) were imaged with the HRT. Three ophthalmologists majoring in glaucoma traced the disc margin with a contour line. One of these observers, repeatedly traced the disc margin with contour line in triplicate at three different times. Eleven topographic parameters of optic nerve head (including disc area, cup area, cup/disc area ratio, rim area, cup volume, rim volume, mean cup depth, maximum cup depth, cup shape measure, mean retinal nerve fiber layer thickness, sectional area of retinal nerve fiber layer) were analyzed with HRT software (version 2.01). Intraclass coefficients (ICC) and agreement of result estimation (kappa value) were calculated. Results The ICCs results among three observers on 12 parameters of optic nerve head topograph were 0.976～0.999, which showed almost perfect agreement; and the kappa value were 0.649～0.767, which showed substantial agreement. The ICC of the same observer in different times were 0.983～0.999, which showed almost perfect agreement; and the Kappa values were 0.810～0.951, which showed substantial agreement. Conclusions Tracing the optic nerve head with contour line on HRT image is substantial to almost perfect within both interobserver and intraobserver in experienced ophthalmologist. This procedure is suitable for clinical diagnosis and follow-up observation of glaucoma.
出处
《中华眼科杂志》
CAS
CSCD
北大核心
2003年第8期471-475,共5页
Chinese Journal of Ophthalmology
基金
广东省重点科技攻关基金资助项目 (A0 5 2 0 0 10 43 )
