遠隔眼科診療における前眼部検査のための従来型および3D半自動照明スリットランプの比較

Accurate and timely assessment of the anterior segment of the eye is vital for the early detection and management of ocular conditions, like cataracts, keratitis, and other corneal diseases.

This study compares two methods for examining the anterior segment of the eye: conventional slit lamp examination, the gold standard, and a novel three-dimensional semi-automated lighting slit lamp examination. The objectives are to evaluate the correlation between grading scores of ocular signs using standardised scales and determine the sensitivity and specificity of the novel approach to diagnosis.

A randomised, prospective, and repeated-measures design was employed. Participants, candidates for cataract surgery, were recruited from an ophthalmology clinic and included pre-operative and short-term post-operative groups. The pre-operative group was assessed for cataracts and iridocorneal angles, while the post-operative group was evaluated for anterior chamber reactions, keratitis, and corneal opacities. Standardised grading scales, like Contact Lens Complications Report, Standardisation of Uveitis Nomenclature, Van Herrick grading, and Lens Opacities Classification System III, were applied to categorise ocular diseases by morbidity levels, from 1 (low) to 5 (high).

A total of 95 participants (72.17 ± 7.62 years; 59% F, 41% M) were included, with 43% in the pre-operative (phakic) and 57% in the post-operative (pseudo-phakic) patients. The intra-class correlation coefficient demonstrated good to excellent correlation (≥0.75) for most clinical findings, with moderate correlation (0.5 to 0.75) for the iridocorneal angle. Sensitivity ranged from 65% to 67% for low-morbidity diseases and 87% to 95% for moderate-morbidity diseases. Specificity was high for low-morbidity diseases (96% to 100%) and moderate for moderate-morbidity diseases (73% to 87%).

A good to great correlation exists between the two methods, and the novel method shows potential as a reliable alternative to the conventional method, with good sensitivity to moderate diseases and high specificity across all conditions.