Ophthalmology in China

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The clinical specificity and sensitivity of tele-ophthalmology screening for ocular surface disease based on fundus photography

LIANG Qing-feng, LI Ran, PAN Zhi-qiang, DENG Shi-jing, LI Jian-jun, XU Liang, WANG Ning-li.   

  1. Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing Tongren Hospital, Capital Medical University, Beijing 100005, China
  • Received:2016-04-17 Online:2016-08-25 Published:2016-08-02
  • Contact: LIANG Qing-feng, Email: lqflucky@163.com

Abstract: Objective To evaluate the clinical specificity and sensitivity of tele-ophthalmology screening criteria for ocular surface disease(OSD)based on fundus photography. Design Evaluation of diagnosis technique. Participants 30 cases of every kind of OSD were the test group, and the 10 normal person ocular surface photos were the control group. Methods The tele-ophthalmology screening criteria for OSD (conjunctival hemorrhage, conjunctivitis, pingueculae, pterygium, band-shaped corneal dystrophy, keratitis, corneal dystrophy, corneal scar, and eyelid tumor) were evaluated with gold standard, ocular surface images obtained by slit lamp camera. Two kinds of photos were asked for the senior corneal ophthalmologists (LQF and DSJ) for a double-blind diagnosis. The clinical specificity and sensitivity of tele-ophthalmology screening criteria was analyzed with Fisher exact probability method of SPSS software. Main Outcome Measures Specificity and sensitivity of tele-ophthalmology screening criteria for OSD. Result The sensitivity and specificity of the diagnosis of conjunctival hemorrhage, the zonal degeneration of cornea, and the imaging diagnosis of eyelid tumors were all up to 100% (confidence interval 92%~100%). The diagnostic sensitivity and specificity of pterygium, corneal scar and keratitis were more than 80%, the sensitivity was 93%, 83% and 83%, respectively; specificity were all 100%. While the diagnostic sensitivity of pingueculae, conjunctivitis, corneal dystrophy were less than 80%, respectively 70%, 60% and 63%, and the diagnostic specificity were higher (100%, 80% and 100%). Meanwhile, the comparative study found that the sensitivity of the chronic keratitis 100% (92%~100%), diagnostic sensitivity of remaining keratitis was lower than 80%. Conclusion Conjunctival hemorrhage, corneal degeneration, and eyelid tumors can be accurately diagnosed by tele-ophthalmology screening based on the fundus camera, and the diagnostic sensitivity of the pingueculae, conjunctivitis and corneal dystrophy was low. Ocular surface images obtained by fundus camera were less sensitive to differentiate the type of keratitis. (Ophthalmol CHN, 2016, 25: 260-264)

Key words: ocular surface disease, teleophthalmology screening, specificity, sensitivity