光学相干断层扫描诊断息肉状脉络膜血管病变的敏感性和特异性

发布时间：2018-04-30 04:02

本文选题：光学相干断层扫描 + 息肉状脉络膜血管病变　；参考：《南方医科大学学报》2017年02期

【摘要】：目的通过评价频域光学相干断层扫描(SD OCT)诊断息肉状脉络膜血管病变(PCV)的敏感性和特异性以及在鉴别PCV和渗出型年龄相关性黄斑变性(w AMD)方面的价值,制定一个相对完善的SD OCT诊断PCV标准。方法回顾性分析西安交通大学第二附属医院眼科在2012年8月~2016年6月间收治的(62)例(63只眼)初诊为PCV或w AMD患者的临床特征,通过分析眼底照相、荧光素眼底血管造影及吲哚菁绿造影最终确诊为PCV者为24例(25只眼),w AMD者38例(38只眼)。当这些患者的SD OCT图像在尖锐的视网膜色素上皮层脱离峰、双层征、多发视网膜色素上皮层脱离、视网膜色素上皮层脱离切迹、代表息肉的低反射腔、高反射硬性渗出这6条特征中,满足第1或第2条时,其余特征至少满足1条可诊断PCV;不满足第1和第2条时,其余特征至少满足3条可诊断为PCV。基于SD OCT的诊断与基于金标准吲哚菁绿造影的诊断相比较,评价其敏感性及特异性。结果确诊为PCV的25只患眼中有23只眼(92.0%)满足SD OCT诊断PCV标准,确诊为w AMD的38只患眼中则有4只眼(10.5%)满足SD OCT诊断PCV标准。SD OCT诊断PCV的敏感性和特异性分别为92.0%和89.5%。结论本研究提供了一个敏感性和特异性均高的SD OCT诊断PCV的标准。SD OCT在鉴别PCV和w AMD方面显示出了较大的优越性。
[Abstract]:Objective to evaluate the sensitivity and specificity of frequency domain optical coherence tomography (SD OCTs) in the diagnosis of polypoid choroidal angiopathy (PCV) and its value in differentiating PCV from exudative age-related macular degeneration. To establish a relatively perfect standard for the diagnosis of PCV by SD OCT. Methods the clinical features of 63 eyes of 62 cases of ophthalmology admitted from August 2012 to June 2016 in the second affiliated Hospital of Xi'an Jiaotong University as PCV or w AMD were retrospectively analyzed. Fundus fluorescein angiography and indocyanine green angiography were confirmed as PCV in 24 cases (25 eyes), 38 eyes (38 eyes) with AMD. When the SD OCT images of these patients were in the sharp retinal pigment epigastric detachment peak, double layer sign, multiple retinal pigment epithelium detachment, retinal pigment epithelium detachment notch, representing the polyp's low reflex cavity, In the case of hyperreflex rigid exudation, the other features can be diagnosed by at least one of them when they satisfy Article 1 or 2, and at least 3 of them can be diagnosed as PCVs if they do not satisfy Article 1 and Article 2. The sensitivity and specificity of SD OCT based diagnosis were compared with those based on gold standard indocyanine green angiography. Results in 25 eyes of PCV, 23 eyes (92.0 eyes) met the diagnostic PCV criteria of SD OCT and 4 eyes (10.5 eyes of 38 eyes diagnosed as w AMD). The sensitivity and specificity of SD OCT diagnostic PCV standard .SD OCT for PCV were 92.0% and 89.5%, respectively. Conclusion this study provides a standard for the diagnosis of PCV by SD OCT with high sensitivity and specificity. SD OCT is superior in differentiating PCV from w AMD.
【作者单位】：西安交通大学第二附属医院眼科;
【基金】：陕西省科技攻关项目(2012K19-05-05)
【分类号】：R773.4

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