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糖尿病视网膜病变查SIMPLE分类的可复制性及其与当前意大利指南的比较

Maria Carla Donati^1,2, Lorenzo Cifarelli^1,2, Alberto Morelli^1,3

¹Department of NEUROFARBA, University of Florence, Firenze, Italy.

European journal of ophthalmology

|August 7, 2024

概括

糖尿病视网膜病变 (DR) 的新SIMPLE分类显示在分级者之间具有很好的可重复性,超过了目前的意大利DR查指南 (IG). 这提高了糖尿病患者可推性决定的标准化.

科学领域:

眼科医生眼科眼科
医疗成像医学成像
糖尿病视网膜病变查糖尿病视网膜病变查

背景情况:

糖尿病视网膜病变 (DR) 是糖尿病患者视力丧失的主要原因.
准确和可重复的分类系统对于有效的DR查和管理至关重要.
当前的选指南可能在标准化和评分员之间的协议方面存在局限性.

研究的目的:

评估SIMPLE (单字段图像多个参数定义的病变范围) 分类对DR查的可重复性.
为了比较SIMPLE分类的协议与目前的意大利指南 (IG) 关于DR和糖尿病黄斑病 (DMac) 的分期和转诊率.
在多中心环境中评估新自动分类系统的性能.

主要方法:

一个回顾性,观察性,多中心研究,涉及1000张糖尿病患者的视网膜底部图像.
三位眼科医生评估了DR病变的图像,并使用IG和自动化SIMPLE分类来分配阶段.
使用kappa统计数据分析了DR和DMac分阶段和转诊率的级别间,中心内和中心间协议.

主要成果:

与IG相比,SIMPLE分类在DR (kappa 0.95对0.86) 和DMac (kappa 0.96对0.78) 两方面都显示了分级者之间更高的一致性.
与IG (0.91) 相比,SIMPLE (0.99) 的转诊率一致性明显高于IG (0.91).
这些发现在中心内部和中心间分析中是一致的.

结论:

简单分类在DR查等级器中表现出极好的可重复性.
简单的分类提供了与当前的意大利指南相比或更高的性能,提高了标准化.
这种新方法提高了关于DR查计划中患者可推性的决策的一致性.

关键词:

糖尿病性黄斑胀 < 视网膜糖尿病视网膜病变 < 视网膜预防医学/查 <社会经济学和医学教育/眼科视网膜检查的技术 < 视网膜远程医疗<社会经济学和医学/眼科教育.

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