何璐; 陈长征; 易佐慧子; 王晓玲; 许阿敏; 刘珏君

doi:10.3760/cma.j.cn115989-20210914-00513

点赞 0
分享 0
收藏 0
纠错

• 临床研究 •

多光谱眼底分层成像在中心性浆液性脉络膜视网膜病变中的应用价值

中华实验眼科杂志, 2021,39(12) : 1075-1079. DOI: 10.3760/cma.j.cn115989-20210914-00513

摘要

目的

探讨多光谱眼底分层成像(MSI)在中心性浆液性脉络膜视网膜病变(CSC)中的应用价值。

方法

采用诊断试验研究方法，收集2017年9月至2018年5月于武汉大学人民医院眼科中心就诊的黄斑疾病患者69例85眼，其中男62例77眼，女7例8眼；平均年龄(48.0±11.2)岁。根据是否患CSC分为CSC组45例61眼和非CSC组24例24眼。采集所有患者彩色眼底照相、荧光素眼底血管造影(FFA)、吲哚菁绿眼底血管造影、频域光相干断层扫描和MSI图像。以FFA作为金标准，计算MSI诊断CSC的灵敏度、特异度、假阳性率、假阴性率、阳性预测值和阴性预测值，采用Kappa一致性检验评价MSI与FFA诊断CSC的一致性，评估MSI对CSC的诊断价值。

结果

MSI诊断CSC的灵敏度为88.5%，特异度为91.7%；假阳性率为8.3%，假阴性率为11.5%，阳性预测值为96.4%，阴性预测值为75.9%，Kappa值为0.754。MSI与FFA检查结果比较，差异无统计学意义(χ²＝1.780，P＝0.180)。在MSI各个波长图像上，620~850 nm波长图像显示视网膜色素上皮(RPE)渗漏点效果更佳，呈高反射信号，590~810 nm波长图像显示浆液性神经上皮脱离区边界清晰，660~850 nm波长图像显示浆液性神经上皮脱离区外的RPE损害更清晰。

结论

MSI与FFA诊断CSC的一致性较好，可以作为CSC的一种有效的无创检查手段。

引用本文: 何璐, 陈长征, 易佐慧子, 等. 多光谱眼底分层成像在中心性浆液性脉络膜视网膜病变中的应用价值 [J] . 中华实验眼科杂志, 2021, 39(12) : 1075-1079. DOI: 10.3760/cma.j.cn115989-20210914-00513.

参考文献导出: Endnote NoteExpress RefWorks NoteFirst 医学文献王

扫描看全文

正文

作者信息

基金 0 关键词 0

English Abstract

阅读 0 评论 0

相关资源

引用 | 论文 | 视频

版权归中华医学会所有。

未经授权，不得转载、摘编本刊文章，不得使用本刊的版式设计。

除非特别声明，本刊刊出的所有文章不代表中华医学会和本刊编委会的观点。

中心性浆液性脉络膜视网膜病变(central serous chorioretinopathy，CSC)是由于脉络膜血管通透性增强继发视网膜色素上皮(retinal pigment epithelium，RPE)屏障功能受损所导致的局限性视网膜神经上皮脱离。目前CSC诊断主要依赖荧光素眼底血管造影(fundus fluorescein angiography，FFA)和吲哚菁绿眼底血管造影(indocyanine green angiography，ICGA)，但二者均为有创检查。多光谱眼底分层成像(multispectral fundus imaging，MSI)系统使用多个单色发光二极管光源投射入眼底，利用不同波长光谱投射到眼底不同深度的组织，不同组织吸收和反射光谱也不同，可获取眼底不同组织层次和结构的图像^[1,2]。MSI具有超宽的光谱范围(520~850 nm)，真正实现了对视网膜、脉络膜的非侵入性直接成像^[3]。关于MSI在CSC中应用的研究报道较少^[4]。本研究拟观察在MSI上CSC患眼的影像特点，评估其临床应用价值。

贡献者信息

何璐

武汉大学人民医院眼科中心　430060

陈长征

武汉大学人民医院眼科中心　430060

易佐慧子

武汉大学人民医院眼科中心　430060

王晓玲

武汉大学人民医院眼科中心　430060

许阿敏

武汉大学人民医院眼科中心　430060

刘珏君

武汉大学人民医院眼科中心　430060

通信作者

陈长征

武汉大学人民医院眼科中心　430060

Email：whuchenchzh@163.com

关键词

视网膜疾病/诊断; 中心性浆液性脉络膜视网膜病变; 荧光素血管造影术; 多光谱眼底分层成像;

利益冲突

所有作者均声明不存在利益冲突

历史

出版日期：2021-12-10

收稿日期：2021-03-14

修回日期：2021-10-18

本文编辑

刘艳施晓萌

Clinical Sciences

Application of multispectral fundus imaging in central serous chorioretinopathy

Lu He, Changzheng Chen, Zuohuizi Yi, Xiaoling Wang, Amin Xu, Juejun Liu

Published 2021-12-10

Cite as Chin J Exp Ophthalmol, 2021, 39(12): 1075-1079. DOI: 10.3760/cma.j.cn115989-20210914-00513

Abstract

Objective

To explore the application of multispectral fundus imaging (MSI) in central serous chorioretinopathy (CSC).

Methods

A diagnostic test study was conducted.Eighty-five eyes from 69 patients with macular diseases were enrolled in Renmin Hospital of Wuhan University from September 2017 to May 2018.There were 62 males (77 eyes) and 7 females (8 eyes) among the 69 patients with an average age of (48.0±11.2) years.The patients were divided into CSC group (45 cases, 61 eyes) and non-CSC group (24 cases, 24 eyes) according to whether suffering from CSC or not.Color fundus photography, fundus fluorescein angiography (FFA), indocyanine green angiography, spectral domain-optical coherence tomography and MSI were performed in the two groups and the images were collected.With FFA as the gold standard, the sensitivity, specificity, false positive rate, false negative rate, positive predictive value and negative predictive value of MSI in the diagnosis of CSC were calculated.Kappa consistency test was used to evaluate the consistency of MSI and FFA in diagnosing CSC, and to evaluate the diagnostic value of MSI in CSC.This study protocol adhered to the Declaration of Helsinki and was approved by an Ethics Committee of Renmin Hospital of Wuhan University (No.WDRY2019-K037). Written informed consent was obtained from each subject prior to any medical examination.

Results

The sensitivity, specicity, false positive rate, false negative rate, positive predictive value and negative predictive value of MSI for identifying CSC were 88.5%, 91.7%, 8.3%, 11.5%, 96.4% and 75.9%, respectively.The Kappa coefficient of agreement was 0.754.There was no significant difference in the identification of CSC between MSI and FFA (χ²=1.780, P=0.180). Hyper-reflective signals corresponding to the leakage points were better detected with MSI images at 620-850 nm wavelength.The clear boundary of serous neuroepithelial detachment area was better detected with MSI images at 590-810 nm wavelength.The retinal pigment epithelium damage was better detected with MSI images at 660-850 nm wavelength.

Conclusions

There is a good consistency between MSI and FFA.MSI can be an effective noninvasive inspection method for CSC.

Key words:

Retinal diseases/diagnosis; Central serous chorioretinopathy; Fluorescein angiography; Multispectral fundus imaging

Contributor Information

Lu He