基于体检中心的机会性眼病筛查的效果评价  

Feasibility and effectiveness of a health examination center-based opportunistic eye diseases screening

作　　者：张绍丹[1] 梁远波 孙晶 柳姗姗[1] 许林 王海林[1] 刘驰[1] 李若溪[1] 

机构地区：[1]沈阳市第四人民医院眼科沈阳市眼病中心重点实验室,110031 [2]温州医科大学附属眼视光医院,325027

出　　处：《中华实验眼科杂志》2017年第12期1120-1125,共6页Chinese Journal Of Experimental Ophthalmology

基　　金：沈阳市临床医学特色专科建设项目（2014-2016）;沈阳市重点科技研发计划项目（17-230-9-03）

摘　　要：背景盲和低视力是中国重大的公共卫生问题，诊断延迟是导致不可逆性视力损伤的重要原因。构建简单易行、低成本高效益、易于推广的高危人群筛查和转诊模式，提高人群中未诊断和未治疗的视觉损伤患者的检出率和就诊率对中国眼健康和眼保健服务具有重要意义。目的评价基于体检中心的机会性眼病筛查的可行性和有效性。方法采用横断面调查。对2016年4-9月在沈阳市第四人民医院体检中心进行健康体检的人群进行日常生活视力、眼压和免扩瞳眼底照相检查。眼底照片由2名眼科医生分别进行阅片和诊断，对于结果不一致的图像由第3位眼科医生进行判别。以世界卫生组织2009年盲和视觉损伤标准，按日常生活视力计算受检者中盲和中重度视觉损伤的比例。根据眼底阅片结果分析可疑青光眼、糖尿病视网膜病变（DR）、视网膜静脉阻塞等疾病的检出率。结果本项目6个月内共纳入15303名受检者，其中15197人完成了检查，受检率为99．3％。发现盲12例，占0．08％，中重度视觉损伤355例，占2．34％。结合眼压及免扩瞳眼底照相筛查出可疑青光眼患者228例，占1．50％，黄斑前膜80例，占0．53％，DR63例，占0．41％，视网膜分支静脉阻塞37例，占0．24％，黄斑变性14例，占0．09％，黄斑裂孔9例，占0．06％，可疑高眼压征358例，占2．36％。超过95％的可疑眼病患者未接受过任何眼科检查和相应治疗。结论基于体检中心的机会性眼病筛查高效、简便、可行、易于推广，可能成为中国防盲治盲以及眼健康服务中的可选择模式。Background Blindness and low vision represent significant public health issues in China. Late diagnosis is the major reason for the irreversible vision impairment. A feasible, cost-effective screening and referral program is very important for the eye health care, prevention and treatment of blindness in China. Objective This study was to evaluate the feasibility and effectiveness of a health examination center-based opportunistic eye disease screening program. Methods This was a cross-sectional study. Subjects undergoing a routine physical examination at the health examination center of the Fourth People＇s Hospital of Shenyang were invited to attend this program. Presenting visual acuity, intraocular pressure, and nonmydriatic fundus photography were obtained. Optic disc photographs were evaluated independently by two ophthalmologists. Blindness and moderate to severe vision impairment were defined based on the criteria of World Health Organization Visual Impairment Classification in 2009. Glaucoma,diabetic retinopathy （DR） and other suspected eye diseases were diagnosed according to the fundus photography and intraocular pressure. This study was approved by Ethic Committe of the Fourth People＇s Hospital of Shenyang,the informed consent of each subject was obtained. Results Totally, 15 303 subjects were enrolled and 15 197 of them finished the exanimations,giving a response rate of 99.3%. The overall percentage of blindness and moderate to severe visual impairment was 0.08% （ 12/15 197） and 2.34% （355/15 197）. Two hundred and twenty-eight （1.50%） subjects were defined as glaucoma suspects and 80 individuals （0.53%） were diagnosed as epimacular membrane. Other suspected eye diseases included DR （0.41%）, branchial retinal vessel occlusion （0. 24% ） ,macular degeneration （0.09%） ,and macular hole （0. 06% ）. More than 95% of the eye disease suspects have never been previously diagnosed or treated. A total of 358 subjects （2. 36% ） were defined as ocular hypertension suspec

关 键 词：机会性眼病筛查 防盲治盲 眼健康 

分 类 号：R770.4[医药卫生—眼科]