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早产儿眼病的两种筛查模式效果评价

         

摘要

·AIM:To investigate and compare the application of two screening models in the detection of retinopathy of prematurity (ROP). ·METHODS: The clinical data of 600 premature infants (1200 eyes) who underwent screening of eye diseases in the Department of Ophthalmology during the period from January 2016 to January 2017 were analyzed retrospectively. The fundus lesions were examined with binocular indirect ophthalmoscope (BIO) and the third generation of wide-angle digital retinal imaging system (RetCam Ⅲ). The examination results and adverse events during operation were statistically analyzed. ·RESULTS:In 1200 eyes of 600 patients,the probabilities of ROP detected by BIO and RetCam Ⅲ were 10.92% and 10.75%, respectively (P>0.05). With BIO as the golden standard, the accuracy, sensitivity, specificity, positive predictive value and negative predictive value of RetCam Ⅲ in examining ROP were 98.67%, 93.13%, 99.35%, 94.57% and 99.16%, respectively. There was no significant difference in the stage of ROP detected by BIO or RetCam Ⅲ (P>0.05). The probabilities of non-ROP lesions examined by BIO and RetCam Ⅲ were 4.83% and 4.58%, respectively (P>0.05). With BIO as the golden standard, the accuracy, sensitivity, specificity, positive predictive value and negative predictive value of RetCam Ⅲ in examining fundus non-ROP diseases were 99.67%, 94.83%, 99.91%, 98.21% and 99.74%, respectively. During the screening of BIO and RetCam Ⅲ,there were 17 cases (2.83%) and 7 cases(1.17%) with adverse events, respectively (P0.05);以BIO为"金标准",RetCam Ⅲ检查ROP的准确性、敏感性、特异性、阳性预测值、阴性预测值分别为98.67%、93.13%、99.35%、94.57%、99.16%.BIO、RetCam Ⅲ检查 ROP 分期结果比较,差异无统计学意义(P>0.05).BIO检查眼底非ROP病变的几率为4.83%,与RetCam Ⅲ(4.58%)比较,差异无统计学意义(P>0.05);以BIO为"金标准",RetCamⅢ检查眼底非ROP病变的准确性、敏感性、特异性、阳性预测值、阴性预测值分别为99.67%、94.83%、99.91%、98.21%、99.74%.BIO筛查过程中17例(2.83%)出现不良事件,与RetCam Ⅲ的7例(1.17%)比较,差异有统计学意义(P<0.05).结论:RetCam Ⅲ检查ROP及早产儿眼底非ROP病变结果与BIO 基本一致,但在减少操作过程中的不良事件上RetCam Ⅲ更具优势.

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