北京市两个街道50岁以上居民免散瞳眼底照相筛查眼底病的初步研究  

The preliminary study of screening for fundus diseases with digital nonmydriatic fundus camera among residents of 50-year-old or elder in 2 communities in Beijing

作　　者：韩毳[1] 徐青[1] 刘宁[1] 冯慧萍[1] 侯宝杰[1] 吴海洋[1] 

机构地区：[1]武警总医院眼科,北京100039

出　　处：《眼科》2013年第4期230-233,共4页Ophthalmology in China

摘　　要：目的探讨免散瞳眼底照相在社区50岁以上居民中眼底病筛查中的可行性及应用价值。设计横断面调查。研究对象北京市海淀区万寿路街道和田村街道通过电话通知及海报招募50岁以上的社区居民3742人。方法对研究对象进行日常生活视力、裂隙灯检查,并使用免散瞳数码眼底相机采集眼底像。对眼底照相诊断为黄斑部疾病者,进行相干光断层扫描(OCT)。主要指标眼底病构成比。结果 3742人参与调查,2914例(77.87%)眼底像可用于分析。筛查出视网膜动脉硬化1081例(37.1%);可疑青光眼270例(9.27%);年龄相关性黄斑变性178例(6.11%);糖尿病视网膜病变65例(2.23%);黄斑前膜38例(1.30%);拟诊黄斑裂孔35例(1.20%),星状玻璃体变性26例(0.89%);视网膜有髓神经纤维17例(0.58%);视网膜血管炎15例(0.51%);视网膜静脉阻塞4例(0.14%);视神经萎缩5例(0.17%);视盘血管瘤1例(0.03%);其他眼底病变12例(0.41%)。眼底照相诊断为黄斑变性、黄斑前膜及黄斑裂孔者的OCT诊断一致率为86.90%(219/252)。828例(22.13%)未能获得可供分析的眼底像,其比例随年龄增加而增加。结论使用免散瞳眼底照相可对大多数50岁以上人群进行眼底病筛查,是一种客观、可行的方法。Objective To evaluate the feasibility and value of screening for fundus diseases with digital nonmydriatic fundus cam- era in 50-year-old or eider community citizens. Design cross-sectional survey. Participants 3742 residents aged 50-year-old or elder by telephone notices and posters recruitment from Wanshoulu blocks and Tiancun blocks, Haidian district, Beijing. Methods Fundus pho- tos were taken with digital nonmydriatic fundus camera and slit-lamp microscopic examination of the anterior segment of all subjects was performed after visual acuity examination. Cases screened as macular diseases with photos were undergone optical coherence tomog- raphy （OCT） examination. Main Outcome Measures Composition ratios of fundus diseases. Results Among all the screened 3742 sub- jects, 2914 subjects acquired qualified fundus photos, 13 fundus diseases were screened, including retinal arteriosclerosis （37.1%）, sus- pect glaucoma （9.27%）, aged-related macular degeneration （6.11%）, diabetic retinopathy （2.23%）, asteroid hyalosis （0.89%）, myelinated nerve fibers （0.58%）, retinal vasculitis （0.51%）, epiretinal membrane of macula （1.30%）, suspect macular hole （1.20%）, retinal vein oc- clusion （0.14%）, optic atrophy （0.17%）, optic disc macroaneurysm （0.03%）, other fundus abnormality （0.32%）. Images of macular de- generation, epi-macular membrane and macular hole were compared with OCT scanning, the resuh consistent rate of the two methods is 86.90%. 828 subjects （22.13%） are excluded because their fundus images were unclear and couldn＇t be analyzed. The rate un-evalua- tion of fundus images was increasing with aging. Conclusion It is an objective and feasible screening method for fundus disease with digital nonmydriatic fundus camera in most 50-year-old or eider subjects. （Ophthalmol CHN, 2013, 22： 230-233）

关 键 词：免散瞳眼底照相 眼底病 筛查 

分 类 号：R770.4[医药卫生—眼科]