应用眼底视网膜成像系统RetcamⅢ早期诊断新生儿视网膜母细胞瘤的临床研究

摘要

Objective:To analyze the clinical value of Retcam III in the early diagnosis of neonatal reti-noblastoma using retinal imaging system. Methods:A retrospective analysis was carried out from July 2014 to July 2016 in 75 cases of RB newborns in our department of Ophthalmology and 100 cases of eyes. These pa-tients were treated with binocular indirect ophthalmoscope, RetCam III and B type ultrasonic diagnosis RB. Results:100 eyes were diagnosed with a double eye ophthalmoscope for the gold standard to diagnose the AE phase of the eye condition,the use of RetCam III diagnosis in the A phase is consistent,B,C,D and E there was a small difference,but very close(P> 0.05). Through the analysis of the Kappa coefficient,the 2 kinds of RB staging are consistent,of which the Kappa coefficient was =0.9794, and the 95% confidence interval was 0.9598-0.9991. In 100 eyes,there were 58 eyes in the A-D period. Using binocular ophthalmoscope 132 standard tumor were detected by RetCam,III in the detection of tumor 130, the detection rate was 98.48%. 111 tumor bodies were detected by B type ultrasound,and the detection rate was 84.09% (P<0.05). RetCam III detection occurred in 2 cases of subconjunctival hemorrhage,the incidence rate was 2%,but there was no adverse reaction in corneal contusion,retinal hemorrhage and infection. The overall bad rate was 2%. The bin-ocular ophthalmoscope and B ultrasonic in the above adverse complications were higher,no difference (P>0. 05). This reveals that RetCam III is safe,reliable,and has good prognosis,and is worthy of clinical applica-tion. Conclusion:The early diagnosis of neonatal retinoblastoma by Retcam III (retina imaging system) can be used to diagnose the tumor staging and disease in a timely and accurate way. It has high specificity and de-tection rate,and has high diagnostic value in clinical.%目的:分析应用眼底视网膜成像系统 RetcamⅢ早期诊断新生儿视网膜母细胞瘤的临床研究价值.方法:回顾性分析2014年7月至2016年7月来我院眼科进行就诊RB新生儿患者75例,患眼100例.以上患者分别采用双目间接检眼镜、RetCam Ⅲ及B型超声诊断RB情况.结果:100只患眼中,通过以双目检眼镜为金标准诊断出 A~E 期的患眼情况,采用 RetCam Ⅲ诊断在 A 期是一致的,B期、C期、D期与E期间存在较小的差别,但非常接近(P>0.05).通过Kappa 系数分析,以上2种对RB分期一致性较好,其中,Kappa系数=0.9794,95%可信区间为0.9598~0.9991.100只患眼中,A~D期有58只患眼,采用双目检眼镜共检出瘤体132个为标准,采用 RetCam Ⅲ检出瘤体130个,检出率为98. 48%,比较接近双目检眼镜金标准.B型超声检出瘤体111个,检出率为84.09%(P<0.05).RetCam Ⅲ检测在结膜下出血发生2例,发生率为2.00%,而在角膜挫伤、视网膜出血、感染等方面无不良反应,总体不良率为2.00%,而双目检眼镜及B型超声在以上并发症方面不良率均较高,对比无差异(P>0.05),这揭示RetCam Ⅲ诊断安全、可靠、预后良好,值得临床推广.结论:应用眼底视网膜成像系统RetcamⅢ早期诊断新生儿视网膜母细胞瘤,可以及时准确诊断瘤体分期及病情,具有较高的特异性及检出率,在临床有较高的诊断价值.