糖尿病性视网膜病变诊断中眼底荧光血管造影的价值及指导治疗的作用评价

目的评价糖尿病性视网膜病变诊断中眼底荧光血管造影检查的价值及指导治疗的作用。方法65例(65眼)疑似糖尿病性视网膜病变患者,均接受眼底照相、眼底荧光血管造影检查,将临床诊断结果作为金标准,比较眼底照相、眼底荧光血管造影检查的诊断价值、诊断符合情况。结果65例患者中,临床诊断阳性47例,阴性18例;眼底照相检查阳性47例,阴性18例;眼底荧光血管造影检查阳性47例,阴性18例。将临床诊断结果作为金标准,眼底照相检查的诊断敏感度为87.2%(41/47),特异度为66.7%(12/18),准确度为81.5%(53/65),阳性预测值为87.2%(41/47),阴性预测值为66.7%(12/18);眼底荧光血管造影检查的诊断敏感度为97.9%(46/47),特异度为94.4%(17/18),准确度为96.9%(63/65),阳性预测值为97.9%(46/47),阴性预测值为94.4%(17/18)。眼底荧光血管造影检查的诊断敏感度、特异度、准确度、阳性预测值、阴性预测值均显著高于眼底照相检查,差异具有统计学意义(P<0.05)。临床诊断47例阳性患者中,轻度17例,中度16例,重度14例;眼底照相检查41例真阳性患者中,轻度14例,中度14例,重度13例;眼底荧光血管造影检查46例真阳性患者中,轻度16例,中度16例,重度14例。眼底照相、眼底荧光血管造影检查对轻度、中度、重度糖尿病性视网膜病变的诊断符合率比较差异无统计学意义(P>0.05)。结论糖尿病性视网膜病变的诊断中眼底荧光血管造影检查的价值较眼底照相检查高,更能有效指导治疗。

Evaluation of fundus fluorescein angiography in the diagnosis and treatment of diabetic retinopathy

Objective To evaluate the value of fundus fluorescein angiography in the diagnosis and treatment of diabetic retinopathy.Methods A total of 65 patients(65 involved eyes)with suspected diabetic retinopathy received fundus photography and fundus fluorescein angiography.The clinical diagnosis results were used as the gold standard to compare the diagnostic value and diagnosis conformity of fundus photography and fundus fluorescein angiography.Results Among the 65 patients,47 cases were positive and 18 cases were negative by clinical diagnosis;47 cases were positive and 18 cases were negative by fundus photography;47 cases were positive and 18 cases were negative by fundus fluorescein angiography.Taking the clinical diagnosis results as the gold standard,the diagnostic sensitivity of fundus photography was 87.2%(41/47),the specificity was 66.7%(12/18),the accuracy was 81.5%(53/65),and the positive predictive value was 87.2%(41/47),the negative predictive value was 66.7%(12/18);the diagnostic sensitivity of fundus fluorescein angiography was 97.9%(46/47),the specificity was 94.4%(17/18),the accuracy was 96.9%(63/65),and the positive predictive value was 97.9%(46/47),the negative predictive value was 94.4%(17/18).The diagnostic sensitivity,specificity,accuracy,positive predictive value,and negative predictive value of fundus fluorescein angiography were significantly higher than those of fundus photography,and the difference was statistically significant(P<0.05).47 cases were positive by clinical diagnosis,including 17 mild cases,16 moderate cases,14 severe cases;41 cases were true positive by fundus photography,including 14 mild cases,14 moderate cases,13 severe cases;46 cases were true positive by fundus fluorescein angiography,including 16 mild cases,16 moderate cases and 14 severe cases.There was no statistically significant difference between fundus photography and fundus fluorescein angiography in the diagnosis of mild,moderate and severe diabetic retinopathy(P>0.05).Conclusion Fundus fluorescein angiography is more valuable than fundus photography in the diagnosis of diabetic retinopathy,which can guide the treatment more effectively.