糖尿病视网膜病变筛查方法的比较研究

Comparative investigation of diabetic retinopathy screening methods

目的:通过比较糖尿病性视网膜病变(diabetic retinopathy,DR)不同筛查方法的效果分析,探讨适合大规模DR患者筛查的方案。方法:糖尿病患者75例150眼分别行小瞳孔眼底照相、散瞳直接眼底镜检查、散瞳间接眼底镜检查、散瞳1张50°眼底后极部彩色照片检查及眼底荧光血管造影(fundus fluorescein angiography,FFA)检查。以FFA为金标准,比较上述各检查方法的筛查效果。结果:在Ⅱ和Ⅲ期DR3种筛查方法比较显示直接眼底镜检查、散瞳1张50°眼底后极部彩色照片检查方法与FFA的相关系数有统计学意义。筛查效果分析显示以Ⅲ期DR作筛查的临界值时,散瞳直接眼底镜检查有较高有效性和实用性。结论:散瞳直接眼底镜检查方法可以作为DR的有效筛查工具,且对DRⅡ和Ⅲ期筛查有较高有效性和实用性。

AIM： To investigate a suitable method for large-scale diabetic retinopathy （DR） screening via various methods in this regard. METHODS： Microcoria fundus photography, mydriasis direct ophthalmo-scope check, mydriasis indirect ophthalmoscope check, mydriasis one 50° posterior fundus color digital image check and fundus fluorescein angiography （FFA） were performed on 75 diabetic retinopathy patients （150 eyes）. Screening results were compared with results of FFA which were taken as gold standards. RESULTS： There were significant differences in direct ophthalmoscope check and mydriasis one 50° posterior fundus color digital image check compared with FFA in stage Ⅱ and Ⅲ DR. Screening results showed that mydriasis direct ophthalmo-scope check was more effective and more practicable when stage m DR was taken as critical value in screening. CONCLUSION： Mydriasis direct ophthalmo-scope check seems to be an effective screening instrument for diabetic retinopathy. It is also both effective and realistic in screening stage Ⅱ and Ⅲ diabetic retinopathy.