手持式免散瞳眼底照相在妊娠高血压患者眼底检查中的价值

Value of Handheld Non-Mydriatic Fundus Photography in Fundus Examination of Patients withGestational Hypertension

目的:探讨手持式免散瞳眼底照相在妊娠高血压患者眼底检查中的价值。方法:以111例妊娠高血压患者为研究对象,对其进行桌面式免散瞳眼底照相、手持式免散瞳眼底照相及直接检眼镜眼底检查,以桌面式免散瞳眼底检查结果为金标准,对比其余2种眼底检查方法识别妊娠高血压视网膜病变的敏感度、特异度和准确率,并进行Kappa检验。结果:手持式免散瞳眼底照相、直接检眼镜眼底检查对视网膜病变的检出率分别为80.18%、76.58%,与桌面式免散瞳眼底照相检出率(82.88%)比较差异无统计学意义。手持式免散瞳眼底照相的敏感度为94.57%,特异度为89.47%,准确率为93.69%,Kapp值为0.79;直接检眼镜眼底检查的敏感度为88.04%,特异度为78.95%,准确率为86.48%,Kapp值为0.58。结论:手持式免散瞳眼底照相能够客观真实反映眼底病变,可作为妊娠高血压患者眼底检查方法,尤其在需要连续监测的床边眼底检查中值得推广。

〕Objective:To explore the value of handheld non-mydriatic fundus photography in fundus examination of patients with gestational hypertension.Methods:A total of 111 patients with gestational hypertension were enrolled in the study.They underwent desktop non-mydriatic fundus photography,handheld non-mydriatic fundus photography,and direct ophthalmoscope fundus examination.The sensitivity,specificity and accuracy of the other two fundus examination methods in identifying retinal lesions in patients with gestational hypertension were compared with the results of desktop non-mydriatic fundus examination as the gold standard,and Kappa tests were performed.Results:The detection rates of retinal lesions by handheld non-mydriatic fundus photography and direct ophthalmoscope fundus examination were 80.18%and 76.58%,respectively.There was no statistically significant difference compared with the detection rate of desktop non-mydriatic fundus photography(82.88%).The sensitivity,specificity,and accuracy of handheld non-mydriatic fundus photography were 94.57%,89.47%,and 93.69%,respectively,with a Kappa value of 0.79.The sensitivity,specificity,and accuracy of direct ophthalmoscope fundus examination were 88.04%,78.95%,and 86.48%,respectively,with a Kappa value of 0.58.Conclusion:Handheld non-mydriatic fundus photography can objectively and truthfully reflect retinal lesions and can be used as a fundus examination method for patients with gestational hypertension,especially in bedside fundus examinations that require continuous monitoring.