广角数码儿童视网膜成像系统进行早产儿视网膜病变筛查研究

Screening of retinopathy of premature infants with wide-angle digital imaging system

摘要:

目的：探讨广角数码儿童视网膜成像系统(RetCamⅡ)进行早产儿视网膜病变(ROP)筛查的临床价值。

方法：选择2012-01/2015-12产科符合筛查标准的200例400眼早产儿采用RetCamⅡ进行ROP筛查，以双目间接眼底镜检查结果作为金标准，计算RetCamⅡ筛查早产儿ROP的价值。

结果：本次筛查200例400眼早产儿，双目间接眼底镜检查共检出ROP病变63眼，ROP患病率为15.8%，其中正常337眼、ROPⅠ期42眼、Ⅱ期14眼、Ⅲ期7眼、Ⅳ期0眼、Ⅴ期0眼； RetCam Ⅱ共计筛查出ROP病变64眼，其中误诊5眼、诊断级别降低6眼。RetCam Ⅱ检出结果与双目间接眼底镜检查结果的一致性Kappa值为0.814(P<0.05)。RetCam Ⅱ筛查早产儿ROP病变的灵敏度为93.7%、特异度为98.5%、漏诊率为6.4%、误诊率为1.5%、阳性预测值92.2%、阴性预测值98.8%。

结论：RetCam Ⅱ进行早产ROP筛查具有较高的临床实用价值。

Abstract:

AIM:To investigate the clinical value of wide angle digital imaging system(RetCam Ⅱ)for the screening of retinopathy of premature infants(ROP).

METHODS: A total of 200 cases(400 eyes)in preterm children were selected Jan. 2012 to Dec. 2015 in line with obstetric screening criteria using RetCamⅡ ROP screening children for binocular indirect ophthalmoscopy results as the gold standard, RetCamⅡ for screening value of ROP in premature children.

RESULTS:The screening of 200 cases(400 eyes)in premature infants, binocular indirect ophthalmoscopy were detected 63 eyes with ROP(15.8%), 337 normal eyes, 42 eyes with ROP phase I, 14 eyes with phase II, 7 eyes with phase III, no one with ROP phase IV and ROP phaseⅤ. A total of a 64 eyes with ROP were screened by RetCam II, which the misdiagnosis in 5 eyes, diagnostic level decreased in 6 eyes. The consistency of RetCam II detection results with binocular indirect ocular fundus examination results was 0.814, P<0.05. RetCamⅡfor screening children preterm children ROP lesion sensitivity of 93.7% and a specificity of 98.5%, missed diagnosis rate was 6.4%, misdiagnosis rate was 1.5%, 92.2% positive predictive value, negative predictive value of 98.8%.

CONCLUSION:RetCamⅡin preterm children ROP screening has high clinical value.