某高校退休职工免散瞳眼底照相筛查结果初步分析

Preliminary analysis of community screening results of non⁃mydriatic fundus photography among retired university staff

目的 探讨免散瞳眼底照相技术在高校教职工眼底病筛查中的应用价值,分析高校离退休人员常见眼底病类型。方法 采用横断面研究,对1 056名某高校离退休职工进行视力、裂隙灯检查,并行免散瞳眼底照相,对采集图像进行初步诊断,初步诊断黄斑部疾病者行光学相干断层扫描(OCT)明确诊断;初步诊断糖尿病视网膜病变者行眼底荧光血管造影检查明确诊断;对于杯盘比增大,可疑青光眼患者转诊至上级医院排除早期青光眼;对视网膜动脉硬化分级,分析血压、年龄对视网膜动脉硬化的影响。结果 筛查1 056名离退休人员眼底,933名眼底像可用于分析。筛查出视网膜动脉硬化367例(39.33%),杯盘比增大42例(4.50%),黄斑前膜9例(0.96%),年龄相关性黄斑变性5例(0.54%),黄斑裂孔4例(0.43%),糖尿病视网膜病变3例(0.32%),陈旧性视网膜静脉阻塞1例(0.11%),玻璃体星状变性1例(0.11%)。患者视网膜动脉硬化分级越高,年龄越大,收缩压、舒张压越高,差异有统计学意义(F=543.037,P<0.001;F=245.146,P<0.001;F=47.176,P<0.001)。结论 视网膜动脉硬化是高校离退休职工常见的眼底疾病,血压、年龄影响视网膜动脉硬化的发生发展,免散瞳眼底照相技术方便、快捷,可常规应用于高校教职工体检眼底筛查。

Objective This study was aimed at exploring the application value of non⁃mydriatic fundus photogra⁃phy technology in the screening of fundus diseases among college faculty,and to analyze the common types of fundus diseases among retired university staff.Methods This cross⁃sectional study involved vision and slit lamp examinations of 1056 retired university staff members,and non⁃mydriatic fundus photographic examination.Preliminary diagnosis was based on acquired images.The initial diagnosis of macular disease was confirmed with OCT.Patients with a preliminary diagnosis of diabetic retinopathy underwent fundus fluorescein angiography to confirm the diagnosis.Patients with an elevated cup⁃to⁃disk ratio and suspected glaucoma were referred to a higher⁃level hospital to rule out early glaucoma.The degree of retinal arteriosclerosis in patients with retinal arteriosclerosis was graded,and the influence of blood pressure and age on the retinal arteriosclerosis grade was analyzed.Results Among the 1056 patients screened,933 fundus images were available for analysis.We identified 367(39.33%)cases of retinal arteriosclerosis;42(4.50%)cases of increased cup⁃to⁃disk ratio;9(0.96%)cases of macular epithelium;5(0.54%)cases of age⁃related macular degeneration;4(0.43%)cases of macular hole;3(0.32%)cases of diabetic retinopathy;1(0.11%)case of old retinal vein occlusion;and 1(0.11%)case of vitreous stellate degeneration.Higher grade of retinal arteriosclerosis and older age were associated with higher systolic blood pressure and diastolic blood pressure,and the differences were statistically significant(F=543.037,P<0.001;F=245.146,P<0.001;F=47.176,P<0.001).Conclusions Retinal arteriosclerosis is a common fundus disease among retired college employees.Blood pressure and age affect the occurrence and develop⁃ment of retinal arteriosclerosis.Non⁃mydriatic fundus pho⁃tography can be routinely used in fundus screening among college faculty.