RetcamⅢ数字视网膜照相机在早产儿视网膜病变筛查中的应用
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摘要
目的探讨RetcamⅢ数字视网膜照相机在早产儿视网膜病变筛查中的应用。方法选取2011年11月至2012年12月我院收治的符合筛查标准的300例早产儿,分别采用双目间接检眼镜成像系统和RetcamⅢ数字视网膜照相机进行检查,分别记录两种检测技术的详细结果,采用双目间接检眼镜检测数据为标准对照,分别统计RetcamⅢ数字视网膜照相机的灵敏度、特异度、阳性预测值和阴性预测值。结果 RetcamⅢ数字视网膜照相机和双目间接检眼镜成像系统检测后分别准确诊断50例(16.67%)和48例(16.00%),两组诊断准确率比较,差异无统计学意义(P>0.05)。RetcamⅢ数字视网膜照相机准确诊断50例中,Ⅰ期病变6例,Ⅱ期病变14例,Ⅲ期病变24例,Ⅳ、Ⅴ期病变6例;双目间接检眼镜成像系统准确诊断48例中,Ⅰ期病变7例,Ⅱ期病变11例,Ⅲ期病变24例,Ⅳ、Ⅴ期病变6例;两组病变分期诊断比较,差异无统计学意义(P>0.05)。在ROP诊断方面,RetcamⅢ数字视网膜照相机准确诊断50例,双目间接检眼镜成像系统准确诊断48例,灵敏度高达100.00%,特异度有96.00%,阳性预测值为95.10%,阴性预测值为0.23%。在阈值前病变和阈值病变诊断方面,双目间接检眼镜成像系统准确诊断35例,双目间接检眼镜成像系统准确诊断33例,灵敏度高达100%,特异度有94.29%,阳性预测值为93.55%,阴性预测值为0.16%。结论 RetcamⅢ数字视网膜照相机可以作为早产儿视网膜病变准确、有效、安全的筛查工具。
Objective To observe the application of Retcam Ⅲ digital retinal camera in retinopathy of premature( ROP) screening. Methods T hree hundreds premature infants in our hospital from N ovember 2011 to December 2012 were chosen,the binocular indirect ophthalmoscope imaging systemand R etcam Ⅲ digital retinal camera were used for R O P screening,respectively. The examination results of binocular indirect ophthalmoscope imaging system were set as standard,the sensitivity,specificity,positive and negative predictive values of R etcam Ⅲ digital retinal camera were analyzed. Results The diagnostic accuracy were made using R etcam Ⅲdigital retinal camera and binocular indirect ophthalmoscope imaging system in 50 cases( 16.67%) and 48 cases( 16. 00%),respectively,there was nostatistical difference in accurate rate( P> 0. 05). In 50 cases with R O P diagnosed by R etcam Ⅲ digital retinal camera,periodⅠ lesions were in 6 cases,period Ⅱlesions in 14 cases,period Ⅲ lesions in 24 cases,period Ⅳ,Ⅴ lesions in6 cases; In 48 cases with R O P diagnosed by binocular indirect ophthalmoscope imaging system,periodⅠ lesions were in 7 cases,periodⅡlesions in 11 cases,period Ⅲ lesions in 24 cases,period Ⅳ,Ⅴ lesions in 6 cases,there was nostatistical difference in period diagnosis between twomethods( P > 0. 05). For the diagnostic accuracy,the sensitivity,specificity,positive and negative predictive values of R etcamⅢ digital retinal camera were 100. 00%,96. 00%,95. 10% and 0. 23%,respectively. For the pre-threshold and threshold diagnosis,the sensitivity,specificity,positive and negative predictive values of R etcam Ⅲ digital retinal camera were 100. 00%,94. 29%,93. 55% and0. 16%,respectively. Conclusion R etcam Ⅲ digital retinal camera can be used as a accurate,effective and safe screening tools for ROP.
Objective To observe the application of Retcam Ⅲ digital retinal camera in retinopathy of premature( ROP) screening. Methods T hree hundreds premature infants in our hospital from N ovember 2011 to December 2012 were chosen,the binocular indirect ophthalmoscope imaging systemand R etcam Ⅲ digital retinal camera were used for R O P screening,respectively. The examination results of binocular indirect ophthalmoscope imaging system were set as standard,the sensitivity,specificity,positive and negative predictive values of R etcam Ⅲ digital retinal camera were analyzed. Results The diagnostic accuracy were made using R etcam Ⅲdigital retinal camera and binocular indirect ophthalmoscope imaging system in 50 cases( 16.67%) and 48 cases( 16. 00%),respectively,there was nostatistical difference in accurate rate( P> 0. 05). In 50 cases with R O P diagnosed by R etcam Ⅲ digital retinal camera,periodⅠ lesions were in 6 cases,period Ⅱlesions in 14 cases,period Ⅲ lesions in 24 cases,period Ⅳ,Ⅴ lesions in6 cases; In 48 cases with R O P diagnosed by binocular indirect ophthalmoscope imaging system,periodⅠ lesions were in 7 cases,periodⅡlesions in 11 cases,period Ⅲ lesions in 24 cases,period Ⅳ,Ⅴ lesions in 6 cases,there was nostatistical difference in period diagnosis between twomethods( P > 0. 05). For the diagnostic accuracy,the sensitivity,specificity,positive and negative predictive values of R etcamⅢ digital retinal camera were 100. 00%,96. 00%,95. 10% and 0. 23%,respectively. For the pre-threshold and threshold diagnosis,the sensitivity,specificity,positive and negative predictive values of R etcam Ⅲ digital retinal camera were 100. 00%,94. 29%,93. 55% and0. 16%,respectively. Conclusion R etcam Ⅲ digital retinal camera can be used as a accurate,effective and safe screening tools for ROP.
引文
1 中国内地新生儿专业发展现状调查协作组.国内109家医院早产儿视网膜病防治调查[J].中华实用儿科临床杂志,2013,28(2):86-89.
2 邓燕,于春红,廖瑜俊,杨洋,彭小维,殷小龙.早产儿视网膜病变的临床分析[J].实用临床医学,2009,10(5):90-95.
3 倪颖勤,黄欣,单海冬,俞笳,薛康,常青,等.早产儿视网膜病变七年筛查治疗结果临床分析[J].中华眼底病杂志,2012,28(1):45-48.
4 项道满,周伟,陈锋,毛娅妮.间接检眼镜眼底成像技术支持下的早产儿视网膜病变筛查研究[J].中华围产医学杂志,2009,12(4):289-292.
5 项道满,陈锋,毛娅妮,周红梅.计算机辅助间接检眼镜下正常早产儿眼底与早产儿视网膜病变的特征分析[J].中华眼底病杂志,2008,24(1):26-29.
6 Wu C,Petersen R A,VanderVeen DK.R etcam imaging for retinopathy of prematurity screening[J].J A A PO S,2006,10(2):107-111.
7 罗黎力,陈大鹏,屈艺,母得志.早产儿218例视网膜病变筛查分析[J].中华实用儿科临床杂志,2013,28(14):1058-1061.
8 The C ommittee for the Classification of Retinopathy of Prematurity.An international classification of retinopathy of prematurity[J].A rch O phthalmol,1984,102(10):1130.
9 Early Treatment For Retinopathy of Prematurity Cooperative Group.R evised indications for the treatment of retinopathy of prematurity:results of the early treatment for retinopathy of prematurity randomized trial[J].A rch O phthalmol,2003,121(12):1684-1694.
10 杨军,尹晓娟,李爱华,安育林,罗分平,封志纯.R etcam数字视网膜照像机检测早产儿视网膜病[J].实用儿科临床杂志,2007,22(5):764-765.
2 邓燕,于春红,廖瑜俊,杨洋,彭小维,殷小龙.早产儿视网膜病变的临床分析[J].实用临床医学,2009,10(5):90-95.
3 倪颖勤,黄欣,单海冬,俞笳,薛康,常青,等.早产儿视网膜病变七年筛查治疗结果临床分析[J].中华眼底病杂志,2012,28(1):45-48.
4 项道满,周伟,陈锋,毛娅妮.间接检眼镜眼底成像技术支持下的早产儿视网膜病变筛查研究[J].中华围产医学杂志,2009,12(4):289-292.
5 项道满,陈锋,毛娅妮,周红梅.计算机辅助间接检眼镜下正常早产儿眼底与早产儿视网膜病变的特征分析[J].中华眼底病杂志,2008,24(1):26-29.
6 Wu C,Petersen R A,VanderVeen DK.R etcam imaging for retinopathy of prematurity screening[J].J A A PO S,2006,10(2):107-111.
7 罗黎力,陈大鹏,屈艺,母得志.早产儿218例视网膜病变筛查分析[J].中华实用儿科临床杂志,2013,28(14):1058-1061.
8 The C ommittee for the Classification of Retinopathy of Prematurity.An international classification of retinopathy of prematurity[J].A rch O phthalmol,1984,102(10):1130.
9 Early Treatment For Retinopathy of Prematurity Cooperative Group.R evised indications for the treatment of retinopathy of prematurity:results of the early treatment for retinopathy of prematurity randomized trial[J].A rch O phthalmol,2003,121(12):1684-1694.
10 杨军,尹晓娟,李爱华,安育林,罗分平,封志纯.R etcam数字视网膜照像机检测早产儿视网膜病[J].实用儿科临床杂志,2007,22(5):764-765.