Journal of the Korean Ophthalmological Society 2006;47(5):771-777.
Published online May 31, 2006.
The Detection of Retinal Never Fiber Layer Defect by Modification of Non-mydriatic Digital Fundus Photograph.
Eui Seok Han, Ki Ho Park, Tae Woo Kim, Dong Myung Kim
1Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea. kihopark@snu.ac.kr
2Seoul Artificial Eye Center, Seoul National University Hospital Clinical Research Institute, Seoul, Korea.
3Department of Ophthalmology, Seoul National University Bundang Hospital, Seongnam, Korea.
디지털 무산동 영상의 변환을 이용한 망막신경섬유층 결손의 발견
한의석1,2,박기호1,2,김태우1,3,김동명1,2
Department of Ophthalmology, Seoul National University College of Medicine1, Seoul, Korea Seoul Artificial Eye Center, Seoul National University Hospital Clinical Research Institute2, Seoul, Korea Department of Ophthalmology, Seoul National University Bundang Hospital3, Seongnam, Korea
Correspondence:  Eui Seok Han, M.D.1,2
Abstract
PURPOSE
To evaluate the efficiency of digital retinal nerve fiber layer (RNFL) photographs converted from a non-mydriatic digital fundus camera for detecting RNFL defects. METHODS: Ninety-five eyes were evaluated with both a non-mydriatic digital fundus photograph and a digital RNFL photograph by two glaucoma specialists independently. The red-free, monochrome modified digital fundus photograph was acquired from non-mydriatic digital fundus photographs using Photoshop 7.0. Whether a localized wedge-shaped or diffuse RNFL defect existed or not was evaluated on a non-mydriatic digital fundus photograph and a modified digital fundus photograph, and inter- and intraobserver agreement were also evaluated. Regarding the use of digital RNFL photographs as a standard method, we calculated the sensitivity, specificity, and positive and negative predictive values of the two types of photographs. RESULTS Interobserver agreement (Cohen's kappa values) about localized RNFL defects observable on digital RNFL photographs, non-mydriatic digital fundus photographs, and modified digital fundus photographs were 0.749, 0.634, and 0.793, respectively, but all were 0.417 or less with regard to diffuse RNFL defects. Regarding localized RNFL defects, the sensitivity, specificity, and positive and negative predictive values of modified digital fundus photographs were 85.7%, 95.5%, 85.7% and 94.1%, respectively, showing superiority to those of non-mydriatic digital fundus photographs. But, in cases of diffuse RNFL defect, the sensitivity and specificity of modified digital fundus photographs were 60.0% and 97.8%, respectively, indicating no superiority to non-mydriatic digital fundus photographs. CONCLUSIONS: The localized RNFL defect can be detected more efficiently with modified digital fundus photographs than non-mydriatic digital fundus photographs, but the diffuse RNFL defect cannot.
Key Words: Diffuse retinal nerve fiber layer defect;Modified digital fundus photograph;Non-mydriatic digital fundus photograph;Retinal nerve fiber layer photograph;Wedge-shaped defect


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