实用医学杂志 ›› 2022, Vol. 38 ›› Issue (4): 464-467.doi: 10.3969/j.issn.1006⁃5725.2022.04.013

• 临床研究 • 上一篇    下一篇

基于智能手机的非接触眼底成像筛查糖尿病视网膜病变

曾依云 董文韬 邓铂林   

  1. 四川省医学科学院·四川省人民医院眼科(成都610072)

  • 出版日期:2022-02-25 发布日期:2022-02-25
  • 通讯作者: 董文韬 E⁃mail:stef.dongwentao@126.com
  • 基金资助:
    四川省科技计划项目(编号:2022YFS0234);四川省人民医院青年科研基金(编号:2017QN02);电子科技大学中央高校基金(编号:2672018ZYGX2018J098)

Smartphone ⁃ based noncontact fundus imaging for diabetic retinopathy screening

ZENG Yiyun,DONGWentao,DENG Bolin.   

  1. Department of Ophthalmology,Sichuan Provincial People′ s Hospital,Sichuan Academy ofMedical Sciences,Chengdu 610072,China

  • Online:2022-02-25 Published:2022-02-25
  • Contact: DONG Wentao E⁃mail:stef.dongwentao@126.com

摘要:

目的 评价使用基于智能手机非接触眼底成像技术在城市基层医疗机构筛查糖尿病视网膜病变(DR)的敏感性和特异性。方法 2021 年 4 月 1 日至 2021 年 6 月 31 日于四川省成都市新津区人民医院招募确诊糖尿病的患者,分别使用智能手机非接触眼底成像技术及双目间接检眼镜进行散瞳后的眼底检查并做出诊断。以双目间接检眼镜的检查结果为参考标准,评估使用智能手机非接触眼底成像技术筛查 DR 的敏感性和特异性。结果 共纳入糖尿病患者 143 例 276 眼。以间接检眼镜的诊断结果为标准,使用智能手机非接触眼底成像技术诊断 DR 的总敏感性和特异性分别为 84.1%和 94.2%(Kappa = 0.79):对轻、中度非增殖性糖尿病视网膜病变(NPDR)敏感性和特异性分别为 79.2%和 94.9%(Kappa = 0.73);威胁视力的 DR 敏感性和特异性均为 100%(Kappa = 1)。结论 基于智能手机的非接触眼底成像技术是筛查糖尿病视网膜病变的有效方法,具有较高的敏感性和特异性。作为常规 DR 筛查的低成本替代方法,有助于在医疗资源相对落后的地区提高DR 筛查的覆盖率。

关键词: 糖尿病视网膜病变, 筛查, 智能手机, 双目间接检眼镜

Abstract:

Objective To evaluate the sensitivity and specificity of noncontact fundus imaging based onsmartphone for diabetic retinopathy(DR)screening in urban primary medical institution. Methods We conducteda prospective and comparative study. Participants with diabetes were recruited to conduct fundus screening bysmartphone ⁃ based noncontact fundus imaging and binocular indirect ophthalmoscope(BIO)after mydriasis fromApril 1,2021,to June 31st in People′s Hospital of Xinjin District of Chengdu. With the results of BIO as a refer⁃ence standard,the sensitivity and specificity of smartphone ⁃ based noncontact fundus imaging to screen DR wereevaluated. Results A total of 143 patients of 276 eyes were recruited. Based on the diagnostic result of BIO,theoverall sensitivity and specificity of smartphone noncontact fundus imaging in the diagnosis of DR were 84.1% and94.2%(kappa = 0.79),respectively;the sensitivity and specificity for mild/moderate NPDR were 79.2% and 94.9%(kappa = 0.73),respectively;Both the sensitivity and specificity of VTDR were 100%(kappa = 1). Conclusion Noncontact fundus imaging based on smartphone is an effective method for DR screening with high sensitivity andspecificity. As a low ⁃ cost alternative to conventional DR screening,it may help to improve the coverage of DRscreening in areas with relatively poor medical conditions.

Key words:

diabetic retinopathy, screening, smartphone, binocular indirect ophthalmoscope