免散瞳眼底彩照在糖尿病视网膜病变社区远程筛查中的应用

Application of Non-mydriatic Digital Fundus Camera in Remote Screen of Diabetic Retinopathy for Community Residents

【目的】评估免散瞳眼底彩照用于糖尿病视网膜病变(DR)社区远程筛查的可行性。【方法】92名糖尿病患者184只眼在社区进行1方位、5方位免散瞳眼底彩照并将结果传至医院,分析二者DR检出的一致性并比较所需时间,同时分别分析二者与散瞳后前置镜检查DR检出率的一致性。【结果】1方位、5方位免散瞳眼底彩照分别与散瞳后前置镜检查相比,二者对DR的检出率一致性良好(κ值分别为0.89,0.95);1方位与5方位免散瞳眼底彩照相比,二者对DR的检出率一致性良好,κ=0.95;1方位比5方位免散瞳眼底彩照拍摄时间(s)更短(55.4±5.8 vs 405.9±68.5,P<0.01)。【结论】免散瞳眼底彩照可以用于DR的社区远程筛查,建议以1方位免散瞳眼底彩照为基础的DR社区远程筛查模式作为DR的筛查方法。

【Objective】To evaluate the practicality of non-mydriatic digital fundus camera in the remote screen of diabetic retinopathy for community residents.【Methods】Ninety-two patients(184eyes)with type2diabetes mellitus have been taken1-field and5-field non-mydriatic fundus photography and examination in mydriatic fundus by preplaced-mirror ophthalmoscopy by a ophthalmologist,the results were sent to the hospital with a computer programs.A specialist evaluates the consistency of detectable rate of diabetic retinophathy(DR)among the3methods.The time of taking1-field and5-field non-mydriatic fundus photography is compared.【Results】All the three methods show good consistency in detectable rate of DR compare with each other,theκvalue is0.89for1-field non-mydriatic fundus photography and examination in mydriatic fundus by preplaced-mirror ophthalmoscopy,0.95for1-field and5-field non-mydriatic fundus photography and0.95for5-field non-mydriatic fundus photography and examination in mydriatic fundus by preplaced-mirror ophthalmoscopy,respectively.The1-field non-mydriatic fundus photography spent less time compares with5-field non-mydriatic fundus photography(55.4±5.8vs405.9±68.5s,P<0.01).【Conclusion】The remote screen for diabetic retinopathy in community based on non-mydriatic digital fundus camera is worth promoting,we suggest1-field non-mydriatic fundus photography as a screen method.