目的:通过对散瞳直接眼底镜检查、免散瞳数码眼底照相及眼底荧光造影3种检查方法对可疑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2007-01/2009-01就诊我院门诊和住院确诊的264例糖尿病患者进行散瞳直接眼底镜检查、免散瞳数码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。主要指标散瞳直接眼底镜检查、免散瞳数码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期为筛查阈值时直接眼底镜检查和免散瞳眼底照相的敏感度分别是63.4%,86.8%,特异度分别是76.9%,92.3%,Youden指数分别是41.1%,79.1%,Kappa检验的一致性分别是41.9%,80.7%。以糖尿病视网膜病变2期为筛查阈值时,直接眼底镜检查和免散瞳眼底照相的敏感性分别是65.5%,93.1%,特异性分别是94.7%,97.4%,Youden指数分别是60.3%,90.5%,Kappa检验的一致性分别是39.1%,61.2%。结论:免散瞳数码眼底彩色照相可作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。

·AIM:To evaluate the ability of digital fundus photography and direct funduscopy to detect diabetic retinopathy(DR)in patients with diabetic mellitus(DM)compared with fundus fluorescein angiography(FFA).·METHODS:All 264 cases with diabetes underwent non-mydriatic digital fundus photography,FFA,and direct funduscopy with dilation of their pupils.Then statistics contrast study of direct funduscopy and FFA,non-mydriatic digital fundus photography and FFA were carried out respectively.· RESULTS:In comparison with FFA,mild nonproliferative DR being taken as referable DR,direct funduscopy with dilation of pupils gave a sensitivity of 63.4%,a specificity of 76.9%,and a Kappa statistic of 41.9%,a Youden of 41.1%,digital fundus photography gave a sensitivity of 86.8%,a specificity of 92.3%,and a Kappa statistic of 80.7%,a Youden of 79.1%;moderate nonproliferative DR being taken as referable DR,direct funduscopy with dilation of pupils gave a sensitivity of 65.5%,a specificity of 94.7%,and a Kappa statistic of 39.1%,a Youden of 60.3%,and digital fundus photography gave a sensitivity of 93.1%,a specificity of 97.4%,and a Kappa statistic of 61.2%,a Youden of 90.5%.·CONCLUSION:Digital fundus photography centered at fovea for screening of early DR especially stage DR Ⅱ or more severe.·

R774.1