新型无散瞳全视野ficker电生理记录仪筛查糖尿病视网膜病变的临床价值

Q4 Medicine

中华眼底病杂志 Pub Date : 2020-02-25 DOI:10.3760/CMA.J.ISSN.1005-1015.2020.02.002

Wenqing Li, Yanping Song, Qin Ding

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引用次数: 0

摘要

目的观察手持式非散瞳视觉电生理诊断系统RETeval在糖尿病视网膜病变（DR）筛查中的初步临床应用价值。方法回顾性临床研究。本研究纳入了2017年11月至2018年5月入住中国人民解放军武汉总医院的58名2型糖尿病患者和16名正常受试者。所有患者均未接受任何眼科治疗。所有患者均通过RETeval设备的默认“DR评估协议”模型进行检查，并通过系统测量“DR评分”。FFA结果被用作金标准，DR根据2002年制定的国际DR分级标准进行分级。将患者分为视力威胁DR（VTDR）阳性组和VTDR（−）组、DR（+）组和DR（−）组。使用两个独立样本t检验来比较不同组眼睛之间的内隐时间、幅度和瞳孔面积比。Spearman相关分析用于分析“DR评分”与DR严重程度之间的关系。受试者工作特征曲线下面积（AUC）评估RETeval在检测DR和VTDR中的敏感性和特异性。灵敏度和特异性的阈值通过使用最大尤登指数作为标准来确定。结果DR的AUC为0.936，敏感性为81%，特异性为92%；VTDR的AUC为0.976、灵敏度为96%、特异性为70%。与DR（−）组相比，DR（+）组内隐时间延迟，波幅和瞳孔面积减小（t=-13.43,5.49,6.09；P=0.000010.0000.000），VTDR（+）组内隐时间延迟，波幅和瞳孔面积减小（t=-11.05，7.46，5.73；P=0.000，0.000，0.000）。它与DR的严重程度高度相关。关键词：糖尿病视网膜病变/诊断；视网膜电图

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The clinical value of screening for diabetic retinopathy with a new mydriasis-free, full-feld ficker electrophysiological recording device

Objective To observe the preliminary clinical application value of the handheld non-mydriatic visual electrophysiological diagnostic system RETeval in screening for diabetic retinopathy (DR). Methods Retrospective clinical study. Fifty-eight patients with type 2 diabetes mellitus and 16 normal subjects who were admitted to Wuhan General Hospital of the PLA from November 2017 to May 2018 were enrolled in this study. All patients had not received any ophthalmologic treatment. All patients were examined by the default "DR assessment protocol" model of the RETeval device, and the "DR score" were measured by the system. The FFA results were used as the gold standard, and the DR was graded according to the international DR grading standard established in 2002. Patients were divided into vision threatening DR (VTDR) positive group and VTDR (−) group, DR (+) group and DR (−) group. Two independent sample t tests was used to compare the implicit time, amplitude, and pupil area ratio between eyes of different groups. Spearman correlation analysis was used to analyze the relationship between "DR score" and DR severity. The receiver operating characteristic area under the curve (AUC) assesses the sensitivity and specificity of RETeval in detecting DR and VTDR. The threshold of sensitivity and specificity was determined by using the maximum Youden index as a standard. Results The AUC of DR was 0.936, the sensitivity was 81%, the specificity was 92%; the AUC of VTDR was 0.976, the sensitivity was 96% and the specificity was 70%. Compared with DR (−) group, the implicit time of DR (+) group was delayed and the amplitude and pupil area were decreased (t=-13.43, 5.49, 6.09; P=0.000, 0.000, 0.000). Compared with VTDR (−) group, the implicit time of VTDR (+) group was delayed and the amplitude and pupil area were decreased (t=-11.05, 7.46, 5.73; P=0.000, 0.000, 0.000). The "DR score" was significantly correlated with the severity of DR (r=0.89, P<0.05). Conclusions The "DR score" measured by the RETeval instrument has a high degree of specificity and sensitivity in the diagnosis of DR and VTDR. It is highly correlated with the severity of DR. Key words: Diabetic retinopathy/diagnosis; Electroretinography

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来源期刊

中华眼底病杂志 Medicine-Ophthalmology

CiteScore

0.40

自引率

0.00%

发文量

5383

期刊介绍： Chinese Journal of Ocular Fundus Diseases is the only scientific journal in my country that focuses on reporting fundus diseases. Its purpose is to combine clinical and basic research, and to give equal importance to improvement and popularization. It comprehensively reflects the leading clinical and basic research results of fundus disease disciplines in my country; cultivates professional talents in fundus disease, promotes the development of fundus disease disciplines in my country; and promotes academic exchanges on fundus disease at home and abroad. The coverage includes clinical and basic research results of posterior segment diseases such as retina, uveal tract, vitreous body, visual pathway, and internal eye diseases related to systemic diseases. The readers are medical workers and researchers related to clinical and basic research of fundus diseases. According to the journal retrieval report of the Chinese Institute of Scientific and Technological Information, the comprehensive ranking impact factor and total citation frequency of the Chinese Journal of Ocular Fundus Diseases have been among the best in the disciplines of ophthalmology, otolaryngology, and ophthalmology in my country for many years. The papers published have been included in many important databases at home and abroad, such as Scopus, Peking University Core, and China Science Citation Database (CSCD).