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在临床实践中通过结合ICD-10青光眼严重性分类系统和光学连贯性断层扫描来改善青光眼的病期

Ari Leshno^1,2, Emmanouil Tsamis³, Noga Harizman¹

¹Bernard and Shirlee Brown Glaucoma Research Laboratory, Edward S. Harkness Eye Institute, Department of Ophthalmology, Columbia University Irving Medical Center, 635 W 165th St, New York, NY, 10032, USA.

Eye (London, England)

|June 30, 2023

概括

将光学连贯性断层扫描 (OCT) 与视野 (VF) 测试相结合,可以提高青光眼的分期精度. 24-2VF和OCT组合为临床实践提供了最好的结果,增强了治疗目标设定.

科学领域:

眼科医生眼科眼科
医疗成像医学成像
诊断技术诊断技术的使用

背景情况:

传统上,青光眼严重程度的分期依赖于国际疾病分类第10版 (ICD-10) 框架内的24-2视野 (VF) 测试.
仅使用功能性VF数据来准确分类青光眼存在局限性.

研究的目的:

评估光学连贯性断层扫描 (OCT) 数据的附加值,以及功能性VF数据,以改善临床实践中的玻璃眼病病阶段.
为了比较不同组合的VF测试 (24-2和10-2) 的准确性,与OCT进行青光眼的严重程度分类.

主要方法:

根据ICD-10的指导方针对54只眼睛进行了分类.
用24-2 VF和10-2 VF测试进行了掩盖分级,包括有和没有OCT信息.
通过使用自动化结构-功能拓协议,建立了严重性的参考标准 (RS).

主要成果:

仅VF的分级与RS的分级有显著差异 (卡帕协议:0.26-0.45).
包含OCT与VF测试的分类与RS没有显著差异 (卡帕协议:0.56-0.57).
与单独的VF数据相比,24-2VF和OCT组合显示了较少的严重性高估.

结论:

将OCT结构数据与VF功能数据整合起来,可显著提高青光眼病分期的准确性.
24-2VF和OCT的组合提供了一个更可靠的方法来对青光眼的严重程度进行分类.
这种综合方法使临床医生能够为单个青光眼患者建立更精确的,基于严重程度的治疗目标.

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