北京市部分社区老年人眼病筛查及免散瞳数码眼底照相在眼底黄斑部疾病筛查中的应用

发布时间：2018-07-17 08:21

【摘要】：目的 通过对北京市47个社区的3742位50岁以上老年人的盲和低视力及常见眼病进行筛查从而掌握该区老年人眼病的患病情况并且为老年人眼病的筛查方式提供新的思路。同时，对筛查出的眼底黄斑部疾病进一步进行OCT检查，通过结果的对比得出免散瞳数码眼底照相结果的准确性从而探讨免散瞳数码眼底照相在黄斑部疾病筛查中的应用价值。 方法 首先依次对该群老年人询问眼病及全身病史，运用视力表、裂隙灯及免散瞳数码眼底相机依次对该人群进行视功能、眼前节及眼底检查。之后按照世界卫生组织视力损伤标准进行该群老年人的盲及低视力及各种眼病的患病情况进行流行病学统计。最后对根据免散瞳数码眼底照相筛选出的可疑眼底黄斑部疾病的患者进行OCT检查，通过统计学方法得出两种检查方法诊断眼底黄斑部疾病的一致率。 结果 本次共筛查3742人，其中男1831人，女1911人；年龄50～87岁，平均62.1岁。其中筛查出盲及低视力者397例(5.86%),双眼盲5例(0.13%)、单眼盲97例(2.6%)、双眼低视力167例(4.46%)、单眼低视力367例(9.8%)。筛查出的主要眼科疾病包括：白内障1158人（30.94%），需手术者48人（2.3%）。可疑青光眼917人（24.5%）；其中前房浅者为554人（14.8%）；C/D≥0.6者270人（7.21%）。糖尿病视网膜病变65人（1.74%）；视网膜动脉硬化1081人（28.89%）；其它疾病翼状胬肉72人(1.92%)；其余眼病均少于20人。 除去眼底照相结果黄斑区未照出或不清晰者828人，余下2914人中筛出黄斑部疾病或可疑疾病者266人（7.11%）。其中黄斑前膜者38人（1.02%），黄斑裂孔者35人（0.94%），黄斑变性者193人（5.16%），经与光学相干断层成像扫描（OCT）对比，两种检查方法诊断结果的一致率为75.94%。 结论 北京市该群老年人中眼病的发病仍较高，所以进行老年人眼病的筛查是十分必要的，而本次筛查中采取的筛查模式达到了方便、快捷、准确、客观的进行大规模眼病筛查的要求，，是一种可行的筛查方法。 免散瞳数码眼底照相在黄斑部疾病的检出中具有较高的准确性，而且具有操作简单，成本较低的优点，所以可做为眼底黄斑部疾病筛查的首选方法。
[Abstract]:Objective to investigate the prevalence of blindness and low vision and common ophthalmopathy in 3742 people over 50 years of age in 47 communities of Beijing, and to find out the prevalence of eye diseases among the elderly in this area and to provide a prescription for the screening of ophthalmopathy in the elderly. It provides a new way of thinking. At the same time, Oct was used to screen the fundus macular diseases, and the accuracy of digital fundus radiography was obtained by comparing the results, and the value of digital fundus photography in macular disease screening was discussed. Methods the patients were asked about eye disease and systemic history in turn. Visual function, anterior segment and fundus were examined by visual acuity chart, slit lamp and digital fundus camera. Then according to the World Health Organization (WHO) standard of visual impairment, the blind and low visual acuity of the elderly and the prevalence of various eye diseases were analyzed. Finally Oct was performed on the patients with suspected fundus macular diseases screened by digital fundus radiography. The consistent rate of two methods for diagnosing fundus macular diseases was obtained by statistical method. Results A total of 3742 persons were screened, including 1831 males and 1911 females, with an average age of 62.1 years (50 ~ 87 years). There were 397 cases (5.86%) of blindness and low vision, 5 cases (0.13%) of binocular blindness, 97 cases (2.6%) of monocular blindness, 167 cases (4.46%) of binocular low vision and 367 cases (9.8%) of monocular low vision. The main ophthalmic diseases screened included: cataract 1158 (30.94%), surgery 48 (2.3%). 917 patients (24.5%) had suspected glaucoma, of which 554 (14.8%) had shallow anterior chamber and 270 (7.21%) had C / D 鈮

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