【摘要】 目的通过对散瞳直接或间接眼底镜检查、眼底照相及眼底荧光造影3种检查方法,对疑似糖尿病视网膜病变患者进行检查和评估比较,优化检查程序和方法。方法对2009-02～2011-02间,就诊我院门诊和住院确诊的496例糖尿病患者进行散瞳直接或间接眼底镜检查、眼底照相及眼底荧光造影检查。眼底病专科医师阅片进行诊断,以眼底血管荧光造影诊断为标准。主要指标散瞳直接或间接眼底镜检查、眼底照相方法进行筛查诊断的敏感性、特异性及与眼底血管荧光造影诊断结果的一致性。结果以糖尿病视网膜病变Ⅰ期为筛查阈值时,散瞳直接或间接眼底镜检查和眼底照相的敏感度分别是65.7%、87.1%,特异度分别是77.2%9、3.5%,Youden指数分别是42.3%7、8.9%,Kappa检验一致性分别是43.3%、81.7%;以糖尿病视网膜病变2期为筛查阈值时,直接或间接眼底镜检查和眼底照相的敏感性分别是66.4%、94.2%,特异性分别是94.9%、98.4%,Youden指数分别61.7%、91.5%,Kappa检验的一致性分别是40.2%6、2.3%。结论眼底彩色照相可做为糖尿病视网膜病变Ⅱ期以上糖尿病视网膜病变优化筛查诊断方法。更多还原

【Abstract】 Objective To evaluate the methods of direct or indirect funduscopy,fundus photography and fundus fluorescein angiography in the detection of suspect diabetic retinopathy(DR) patienta.Methods 496 cases with diabetes underwent non-mydriatic photography,FFA,and direct or indirect funduscopy with dilation of their pupils.Then the contrast study of direct funduscopy or indirect funduscopy and FFA,non-mydriatic photography and FFA were carried out respectively.Results In comparison with FFA,mild non proliferative DR being taken as referable DR,direct funduscopy or indirect funduscopy with dilation of pupils gave a sensitivity of 65.7%,a specificity of 87.1%,and a Kappa statistic of 43.3%、81.7%,a Youden index of 42.3%、78.9%,digital fundus photography gave a sensitivity of 77.2%,a specificity of 93.5%,moderate non proliferative DR being taken as referable DR,direct funduscopy with dilation of pupils gave a sensitivity of 66.4%,a specificity of 94.2%,a Youden of 61.7%、91.5%,and digital fundus photography gave a sensitivity of 94.9%,a specificity of 98.4%,and a Kappa statistic of 40.2%、62.3%.Conclusion Digital fundus photography centered at fovea for screening of early DR especially stage DR Ⅱ or more severe.更多还原