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目的:建立一套后发性白内障计算机图像分析系统并对其进行评价。方法:建立家兔后发性白内障模型。充分散瞳后(瞳孔直径>6.5mm),用裂隙灯显微镜拍摄系统(含数码相机、电脑)在同一条件下进行拍照。所得后照图像用于后发性白内障的评分。后发性白内障的评分(PCOscore)=Σ(OD×AIinCR)×2+Σ(OD×AIinOR),其中OD为后发障混浊密度(0到4级),AI为该级别后发障所占评估范围(以视轴为中心直径6mm的后囊膜)的面积百分比,CR为中央3mm区域,OR为外周3～6mm环行区域。为检验系统的可信度,由6名检查者分别评估5幅图像,以检验系统的个体间差异;由同一名检查者在不同日期对5幅图像重复评估5次,以检验系统的个体内差异。结果:当后发障评分为0到1.5时,个体间可信度检验的标准差仅为0.05～0.087,Kruskal-Wallis非参数分析显示差异无统计学意义(H=0.314,P=0.9726).个体内可信度检验的标准差为0.041～0.067,差异也无统计学意义(H=0.613,P=0.9616)。结论:该后发性白内障定量评估系统具有良好的可信度,方便、实用,可用于对后发性白内障进行比较精确的定量分析。为检验不同人工晶状体和手术技巧对后发性白内障形成及发展的作用提供了重要工具。
Objective: To establish and evaluate a set of computerized image analysis system for post-cataract. Methods: A rabbit model of posterior cataract was established. Full dilation (pupil diameter> 6.5mm), with a slit lamp microscope recording system (including digital cameras, computers) under the same conditions for taking pictures. The resulting back-illuminated images are used for the assessment of posterior capsular cataracts. PCOscore = Σ (OD × AIinCR) × 2 + Σ (OD × AIinOR), where OD is the posterior haze density (0 to 4), AI is the level of fatal failure The area percentage of the assessment range (posterior capsular membrane with a 6 mm diameter centered on the visual axis) was CR 3 mm central and OR 3 mm to 6 mm circumferential. In order to test the credibility of the system, five examiners were evaluated by five examiners to test the differences between the systems. Five examinations were repeated on the same examiner on different days for five times to examine the in-vivo difference. Results: The standard deviation of inter-individual reliability test was only 0.05-0.087 when the post-stroke score was 0 to 1.5. The Kruskal-Wallis nonparametric analysis showed no significant difference (H = 0.314, P = 0.9726). The standard deviation of the confidence test in individuals was 0.041 ~ 0.067, with no significant difference (H = 0.613, P = 0.9616). Conclusion: The quantitative evaluation system for posterior capsular cataract has a good credibility, which is convenient and practical. It can be used for more accurate quantitative analysis of posterior capsular cataract. To test the different intraocular lenses and surgical techniques on the formation and development of secondary cataract provides an important tool.