用眼底照相评价受训者应用直接检眼镜的准确性

发布时间：2018-09-19 14:28

【摘要】：目的:用眼底照相评价受训者使用直接检眼镜在诊断筛查各种眼底疾病的效用。方法:对经过临床轮转后的4名眼科硕士研究生进行直接检眼镜培训并考核合格后,随机抽取1名作为本研究的直接检眼镜操作者。于2010年7月至2010年8月在汕头市南澳岛募集到514名50岁或以上的志愿者,共1003只眼。分别使用直接检眼镜于小瞳孔下对志愿者进行眼底检查并记录以及散瞳下行30°彩色眼底照相,最后由一名眼底专科医师对眼底照进行判读,并以眼底图作为参考标准。评价受训者直接检眼镜检查结果与眼底照相在诊断青光眼、糖尿病性视网膜病变、高血压性视网膜病变、视网膜前膜、视网膜色素变性、高度近视、视网膜中央/分支静脉阻塞、年龄相关性黄斑变性的诊断对应关系。结合Kappa值、特异度、诊断符合率、ROC曲线下面积及Logistic回归模型对数据进行综合分析。结果:对于视网膜色素变性、视网膜中央/分支静脉阻塞,直接检眼镜与眼底照诊断效能相近。直接检眼镜与眼底照对糖尿病性视网膜病变诊断效能接近。直接检眼镜与眼底照对高血压性视网膜病变诊断倾向性相似,但诊断共同性结论极弱。检眼镜对青光眼可疑、视网膜前膜、眼底异常有倾向性诊断效能,而眼底照对高度近视、年龄相关性黄斑变性有倾向性诊断效能。结论:经过严格培训的受训者使用直接检眼镜评估眼底病变与客观的眼底照相诊断眼科的常见病与多发病的效能一致。
[Abstract]:Objective: to evaluate the efficacy of direct ophthalmoscope in the diagnosis and screening of various fundus diseases. Methods: four postgraduates of ophthalmology were trained by direct ophthalmoscope after clinical rotation, and one of them was selected as the direct ophthalmoscope operator at random. From July 2010 to August 2010, 514 volunteers aged 50 or above were recruited in Nanao Island, Shantou City, with a total of 1003 eyes. Direct ophthalmoscope was used to examine and record the fundus of volunteers under small pupil, and 30 掳color fundus photography was performed under dilated pupil. Finally, the fundus was interpreted by a fundus specialist, and the fundus image was taken as the reference standard. To evaluate the results of direct ophthalmoscopy and fundus photography in the diagnosis of glaucoma, diabetic retinopathy, hypertensive retinopathy, epiretinal membrane, retinitis pigmentosa, and high myopia. Diagnosis of central / branch retinal vein occlusion and age-related macular degeneration. Combined with Kappa value, specificity, diagnostic coincidence rate, area under ROC curve and Logistic regression model, the data were analyzed synthetically. Results: for retinitis pigmentosa, central / branch retinal vein occlusion, direct ophthalmoscope was similar to fundus radiography. The diagnostic efficacy of direct ophthalmoscope and ophthalmography for diabetic retinopathy was similar. Direct ophthalmoscope is similar to fundus radiography in the diagnosis of hypertensive retinopathy, but the diagnostic concomitant conclusion is very weak. Ophthalmoscope was effective in the diagnosis of glaucoma, abnormal retinal membrane and fundus, while fundus radiography was helpful in the diagnosis of high myopia and age-related macular degeneration. Conclusion: trained trainees use direct ophthalmoscope to evaluate fundus lesions and objective fundus photography in the diagnosis of common eye diseases and frequent diseases.
【学位授予单位】：汕头大学
【学位级别】：硕士
【学位授予年份】：2011
【分类号】：R770.4

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