[1]王子杨,杨文利,李栋军,等.IOLMaster 700对白内障术前患者黄斑疾病的筛查价值[J].眼科新进展,2020,40(12):1180-1184.[doi:10.13389/j.cnki.rao.2020.0262]
　WANG Ziyang,YANG Wenli,LI Dongjun,et al.IOLMaster 700 for screening macular diseases in patients before cataract surgery[J].Recent Advances in Ophthalmology,2020,40(12):1180-1184.[doi:10.13389/j.cnki.rao.2020.0262]
点击复制

IOLMaster 700对白内障术前患者黄斑疾病的筛查价值/HTML
分享到：

《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
40卷
期数:
2020年12期
页码:
1180-1184
栏目:
应用研究
出版日期:
2020-12-05

文章信息/Info

Title:
IOLMaster 700 for screening macular diseases in patients before cataract surgery
文章编号:
1180
作者:
王子杨; 杨文利; 李栋军; 陈伟; 赵琦; 李逸丰; 崔蕊; 沈琳
100730　北京市，首都医科大学附属北京同仁医院北京同仁眼科中心,眼科学与视觉科学北京市重点实验室
Author(s):
WANG Ziyang; YANG Wenli; LI Dongjun; CHEN Wei; ZHAO Qi; LI Yifeng; CUI Rui; SHEN Lin
Beijing Tongren Eye Center,Beijing Tongren Hospital,Capital Medical University; Beijing Key Laboratory of Ophthalmology and Visual Sciences,Beijing 100730,China
关键词:
IOLMaster 700; SS-OCT; 白内障; 光学相干断层扫描; 黄斑疾病
Keywords:
IOLMaster 700;  swept-source optical coherence tomography;  cataract;  optical coherence tomography;  macular disease
分类号:
R776.1
DOI:
10.13389/j.cnki.rao.2020.0262
文献标志码:
A
摘要:
目的　探讨基于SS-OCT技术的生物测量仪IOLMaster 700对白内障术前患者进行黄斑疾病的筛查价值。方法　横断面研究。收集2018年12月就诊于首都医科大学附属北京同仁医院白内障门诊的白内障术前患者208例（312眼），用IOLMaster 700进行生物测量，该设备可通过SS-OCT技术提供1 mm的黄斑中心凹水平扫描图像。所有患者同时行频域光学相干断层扫描（SD-OCT）确定黄斑情况。记录两种检查方法黄斑是否存在病变并记录病变类型，以SD-OCT的结果为标准，计算IOLMaster 700检测黄斑疾病的灵敏度、特异度、假阳性率、假阴性率、一致率、阳性及阴性预测值、阳性及阴性似然比，并绘制ROC曲线。结果　本研究共纳入患眼262眼，排除50眼，其中115眼患有黄斑疾病（43.9%），147眼正常（56.1%）。IOLMaster 700与SD-OCT比较Kappa值为0.52（95%CI 0.42~0.62），说明有中高度一致性（P<0.001）。IOLMaster 700筛查黄斑疾病的灵敏度为56.5%，特异度为93.2%，假阳性率为6.8%，假阴性率为43.5%，一致率为77.1%，阳性预测值为86.7%，阴性预测值为73.3%，阳性似然比为8.31，阴性似然比为0.47，ROC曲线下面积为0.75。其中，诊断黄斑裂孔、黄斑水肿的准确性较高，对于非中心凹处的玻璃体后脱离、黄斑前膜、黄斑劈裂、神经上皮脱离、黄斑退行性改变、玻璃膜疣，IOLMaster 700筛查时容易漏诊。结论　IOLMaster 700可以作为白内障术前筛查是否存在黄斑疾病的工具，但因扫描范围小且图像质量有限，因此不能完全取代SD-OCT检查。
Abstract:
Objective　To study the value of IOLMaster 700 based on swept-source optical coherence tomography for screening macular disease before cataract surgery.Methods　Cross-sectional study. A total of 208 consecutive patients (312 eyes) scheduled for cataract surgery in Beijing Tongren Hospital were collected in December 2018. The biometry examination was performed with IOLMaster 700, which can provide a 1mm horizontal scan of the fovea by swept-source optical coherence tomography (SS-OCT) technology. All patients underwent spectral-domain optical coherence tomography (SD-OCT) to determine the macular condition. Based on the SD-OCT results, we calculated the sensitivity, specificity, false positive rate, false negative rate, agreement rate, positive and negative prediction value, positive and negative likelihood ratio with IOLMaster 700 and drew the ROC curve.Results　There were 262 eyes included in this study, and 50 eyes were excluded. Among them, 115 eyes had macular disease (43.9%) and 147 eyes were normal (56.1%). Compared with SD-OCT, IOLMaster 700 had a kappa value of 0.52 (95% CI 0.42-0.62), indicating a medium to high degree of agreement (P<0.001). The sensitivity of screening macular diseases was 56.5% for IOLMaster 700, and the specificity was 93.2%, the false positive rate was 6.8%, the false negative rate was 43.5%, the agreement rate was 77.1%, the positive predictive value was 86.7%, and the negative predictive value was 73.3 %, the positive likelihood ratio was 8.31, the negative likelihood ratio was 0.47, and the area under the ROC curve was 0.75. In general, the accuracy of diagnosing macular hole and macular edema was high. However, the non-central diseases, including posterior vitreous detachment, epiretinal membrane, macular splitting, neuroepithelial detachment, macular degeneration, drusen, tended to be missed by IOLMaster 700.Conclusion　IOLMaster 700 can be used for screening macular disease before cataract surgery, but due to the limited scanning range and image quality, it cannot completely replace the SD-OCT examination.

参考文献/References:

［1］　HUANG X L,ZHANG Z W,WANG J,MENG X M,CHEN T T,WU Z F.Macular assessment of preoperative optical coherence tomography in ageing Chinese undergoing routine cataract surgery［J］.Sci Rep,2018,8(1):5103.
［2］　ZAFAR S,SIDDIQUI M A R,SHAHZAD R,SHAHZAD M H.Swept-source optical coherence tomography to screen for macular pathology in eyes having routine cataract surgery［J］.J Cataract Refract Surg,2017,43(3):324-327.
［3］　王子杨,杨文利,李栋军,陈伟,赵琦,李逸丰,等.新型生物测量仪Pentacam AXL、IOLMaster 700与IOLMaster 500对白内障眼部生物学参数测量的比较［J］.中华眼科杂志,2019,55(7):515-521.
WANG Z Y，YANG W L，LI D J，CHEN W，ZHAO Q，LI Y F，et al.Comparison of biometry with the Pentacam AXL,IOLMaster 700 and IOLMaster 500 in cataract patients［J］.Chin J Ophthalmol,2019,55(7):515-521.
［4］　KUNERT K S,PETER M,BLUM M,HAIGIS F,SEKUNDO W,SCHUTZE J,et al.Repeatability and agreement in optical biometry of a new swept-source optical coherence tomography-based biometer versus partial coherence interferometry and optical low-coherence reflectometry［J］.J Cataract Refract Surg,2016,42(1):76-83.
［5］　HUANG J H,CHEN H,LI Y,CHEN Z X,GAO R R,YU J J,et al.Comprehensive comparison of axial length measurement with three swept-source OCT-based biometers and partial coherence interferometry［J］.J Refract Surg,2019,35(2):115-120.
［6］　LEE H K,KIM M K.Comparison of a new swept-source optical biometer with a partial coherence interferometry［J］.BMC Ophthalmol,2018,18(1):269.
［7］　TOGNETTO D,PASTORE M R,GIACINTO C D,MERLI R,FRANZON M,DALOISIO R,et al.Swept-source optical coherence tomography biometer as screening strategy for macular disease in patients scheduled for cataract surgery［J］.Sci Rep,2019,9(1):9912.
［8］　HUSSAIN M A,BHUIYAN A,LUU C D,SMITH R H,GUYMER R H,ISHIKAWA H,et al.Classification of healthy and diseased retina using SD-OCT imaging and Random Forest algorithm［J］ .PLoS One,2018,13:e0198281.
［9］　KIM S Y,LEE S H,KIM N R,CHIN H S,JUNG J W.Accuracy of intraocular lens power calculation formulas using a swept-source optical biometer［J］.PLoS One,2020,15(1):e0227638.
［10］　MCALINDEN C,WANG Q M,GAO R R,ZHAO W Q,YU A,LI Y,et al.Axial length measurement failure rates with biometers using swept-source optical coherence tomography compared to partial-coherence interferometry and optical low-coherence interferometry［J］.Am J Ophthalmol,2017,173:64-69.
［11］　HINSCHALL N,LEISSER C,RADDA S,MAEDEL S,FINDL O.Macular disease detection with a swept-source optical coherence tomography-based biometry device in patients scheduled for cataract surgery［J］.J Cataract Refract Surg,2016,42(4):530-536.
［12］　BERTELMANN T,BLUM M,KUNERT K,HAIGIS W,MESSERSCHMIDT A,PETER M,et al.Foveal pit morphology evaluation during optical biometry measurements using a full-eye-length swept-source OCT scan biometer prototype［J］.Eur J Ophthalmol,2015,25(6):552-558.
［13］　KHAN M A,SKIDMORE K,HO A C.Perioperative retina evaluation of the cataract surgery patient［J］.Curr Opin Ophthalmol,2015,26(1):39-44.

备注/Memo

备注/Memo:
N/A
更新日期/Last Update: 2020-12-05