gms | German Medical Science

104. Jahrestagung der Deutschen Ophthalmologischen Gesellschaft e. V. (DOG)

21. - 24.09.2006, Berlin

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Assessment of the accuracy of lacrimal scintigraphy based on a prospective analysis of patients’ symptomatology

Meeting Abstract

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  • A. Fard-Esfahani - Nuclear Medicine Research Center, Tehran University of Medical Sciences, Shariati Hospital, Tehran, Iran
  • A. Gholamrezanezhad - Nuclear Medicine Research Center, Tehran University of Medical Sciences, Shariati Hospital, Tehran, Iran
  • S. Mirpour - Nuclear Medicine Research Center, Tehran University of Medical Sciences, Shariati Hospital, Tehran, Iran
  • M. Eftekhari - Nuclear Medicine Research Center, Tehran University of Medical Sciences, Shariati Hospital, Tehran, Iran
  • M. Saghari - Nuclear Medicine Research Center, Tehran University of Medical Sciences, Shariati Hospital, Tehran, Iran
  • A. Takavar - Nuclear Medicine Research Center, Tehran University of Medical Sciences, Shariati Hospital, Tehran, Iran
  • B. Fallahi-sichani - Nuclear Medicine Research Center, Tehran University of Medical Sciences, Shariati Hospital, Tehran, Iran
  • D. Beiki - Nuclear Medicine Research Center, Tehran University of Medical Sciences, Shariati Hospital, Tehran, Iran
  • Tari A. Sadeghi - Department of Ophthalmology, Tehran University of Medical Sciences, Farabi Hospital, Tehran, Iran

Deutsche Ophthalmologische Gesellschaft e.V.. 104. Jahrestagung der Deutschen Ophthalmologischen Gesellschaft (DOG). Berlin, 21.-24.09.2006. Düsseldorf, Köln: German Medical Science; 2006. Doc06dogSA.08.07

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Veröffentlicht: 18. September 2006

© 2006 Fard-Esfahani et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.

Gliederung

Text

Objective

Dacryoscintigraphy is a noninvasive method frequently used for assessment of the lacrimal drainage system. Sometimes conflicting results with patients’ complaints are obtained, which have no clear explanation. In our hypothesis, follow-up of patients evaluated with dacryoscintigraphy could be helpful in determining possible explanations for these conflicting results.

Methods

38 consecutive patients (76 eyes) who had not previously undergone dacryocystorhinostomy or probing were entered in the study. Following instillation of 4 MBq 99mTc-pertechnetate, a routine procedure of dacryoscintigraphy was performed. After a mean follow-up time of 1.2±0.3 years (range: 0.9-1.6years), all patients were re-assessed clinically.

Results

Using initial patients’ symptoms as the gold standard, the sensitivity, specificity, NPV and PPV of dacryoscintigraphy were calculated to be 82.1%, 75%, 60% and 90.1%, respectively. The kappa value as a measure of agreement was 0.52. Considering the follow-up study as the gold standard, the sensitivity, specificity, NPV and PPV were calculated as follows respectively: 96.3%, 90.4%, 96.3% and 90.4%. The kappa value was 0.86. There were 3 initially symptom-free eyes with obstructive pattern on the scans, which developed epiphora on the follow-up. In fact, these eyes were initially classified as false positive, but follow-up assessment showed that they were true-positive scans in a subclinical state.

Conclusions

Despite certain drawbacks inherent to the technique, dacryoscintigraphy provides valuable independent information and allows more accurate management decisions. In some patients, data obtained from lacrimal scintigraphy could be predictive and it makes possible determination of subclinical nasolacrimal duct obstructions.