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目的:用诊断试验的方法,分析原发性青光眼视野与视网膜神经纤维层厚度改变,进一步验证倍频视野技术(frequency doubling technology,FDT)与光学相干断层扫描(optical coherence tomography,OCT)的诊断效能,比较两者在临床应用中的诊断价值。方法:设计一个前瞻性诊断试验,分别应用OCT和FDT对83例162只青光眼及疑似青光眼进行检测,根据检测结果得出各诊断试验的诊断指标,并对两者进行比较和联合试验。得出两者的验前和验后概率。结果:两者的灵敏度和特异度比较,均有P>0.05。两者的联合灵敏度为88.4%,诊断效能较单纯OCT提高了11.84%,较FDT提高了18.09%。联合特异度为84.42%,诊断效能较单纯OCT提高了29.32%,较FDT提高了19.11%。两者的验前概率为39.51%,验后概率分别为52.83%和57.08%。结论:OCT与FDT在诊断原发性青光眼的应用中有较好的诊断价值,且两者诊断效能的差异不大,两者联合可以大大提高其诊断价值。在临床应用中,还不能单纯依靠OCT或FDT的诊断结果来判定原发性青光眼,对原发性青光眼的诊断尚需进一步检查。
OBJECTIVE: To investigate the diagnostic efficacy of frequency doubling technology (FDT) and optical coherence tomography (OCT) by analyzing the changes of visual field of primary glaucoma and the thickness of retinal nerve fiber layer by diagnostic test. , To compare the diagnostic value of both in clinical application. Methods: A prospective diagnostic test was designed. Eighty-two cases of 162 glaucoma and suspected glaucoma were examined by OCT and FDT respectively. According to the test results, the diagnostic criteria of each diagnostic test were obtained and compared with each other. Obtain both pre-test and post-test probabilities. Results: The sensitivity and specificity of the two were compared, P> 0.05. The combined sensitivity of the two was 88.4%. The diagnostic efficacy was 11.84% higher than that of pure OCT and 18.09% higher than that of FDT. The joint specificity was 84.42%. The diagnostic efficiency was 29.32% higher than that of pure OCT and 19.11% higher than FDT. The pre-test probability of both was 39.51%, and the post-test probabilities were 52.83% and 57.08% respectively. Conclusions: OCT and FDT have a good diagnostic value in the diagnosis of primary glaucoma, and the difference between the two is insignificant. The combination of the two can greatly improve the diagnostic value. In clinical application, the diagnosis of primary glaucoma can not be judged solely by the diagnostic results of OCT or FDT. Further examination is still needed.