眼科 ›› 2015, Vol. 24 ›› Issue (4): 220-225.doi: 10. 13281/j. cnki. issn.1004-4469. 2015. 04. 002

• 论著 • 上一篇    下一篇

远程眼科阅片筛查疾病谱初步分析

张琪  李建军  苏炳男  徐亮  任晓磊  刘丽娟  王爽  徐捷  彭晓燕   

  1. 100005首都医科大学附属北京同仁医院 北京同仁眼科中心 北京市眼科研究所 眼科学与视觉科学北京市重点实验室
  • 收稿日期:2015-06-14 出版日期:2015-07-25 发布日期:2015-08-18
  • 通讯作者: 李建军,Email:jianjunli2005@163.com
  • 基金资助:

    国家科技支撑计划课题(2013BAH19F04;2012BAH05F05);首都医学发展专项基金(首发2011-1016-01)

A preliminary study of screening disease spectrum in image reading center of teleophthalmology

ZHANG Qi, LI Jian-jun, SU Bing-nan, XU Liang, REN Xiao-lei, LIU Li-juan, WANG Shuang, XU Jie, PENG Xiao-yan.   

  1. Beijing Key Lab. of Ophthalmology and Visual Science; Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing 100005, China
  • Received:2015-06-14 Online:2015-07-25 Published:2015-08-18

摘要:

目的 研究远程眼科阅片筛查的疾病谱。设计 回顾性病例系列。研究对象 2015年3-4月北京同仁医院远程眼科阅片中心同一位眼科高级职称医师的连续远程阅片、来自54家中国不同地域基层医院的病例1192例。方法 将上述病历资料用大恒普信远程阅片数据库软件导出后,用Excel软件和SPSS软件进行疾病分类统计。对筛查诊断有疑问病例由两位眼科高级职称医师核对确定。对年龄<50岁及≥50岁的患者,以及患者来自基层医院地理位置(黄河以北及以南)进行不同疾病构成比的比较分析。主要指标 阅片筛查中的疾病构成比。结果 1192例患者中,屈光不正408例(34.3%),白内障273例(22.9%),高血压性视网膜病变228例(19.1%),正常眼底及正视眼160例(13.4%),视网膜动脉硬化114例(9.6%),糖尿病视网膜病变85例(7.1%),黄斑及后极部视网膜前膜57例(4.8%),病理性近视47例(3.9%),青光眼29例(2.4%),可疑青光眼27例(2.3%),视网膜分支静脉阻塞25例(2.1%),糖尿病黄斑水肿21例(1.8%),年龄相关性黄斑变性21例(1.8%)。50岁以下(366例)与50岁及以上(826例)的诊断分别是屈光不正168例(45.9%)与240例(29.1%);正常眼底及正视眼106例(29.0%)与54例(6.5%);白内障19例(5.2%)与254例(30.8%);高血压性视网膜病变23例(6.3%)与205例(24.8%);视网膜动脉硬化4例(1.1%)与109例(13.2%);糖尿病视网膜病变10例(2.7%)与75例(9.1%);黄斑及后极部视网膜前膜0例(0%)与57例(6.9%);青光眼4例(1.1%)与25例(3.0%);视网膜分支静脉阻塞2例(0.5%)与23例(2.8%);年龄相关性黄斑变性0例(0%)与21例(2.5%)。黄河以北(796例)与黄河以南(396例)地区的疾病诊断分别是高血压性视网膜病变172例(21.6%)与56例(14.1%);青光眼12例(1.5%)与17例(4.3%);玻璃体后脱离13例(1.6%)与14例(3.5%)。结论 目前远程眼科阅片筛查诊断中,1/3的患者属于屈光不正;较常见的全身疾病眼部表现主要是高血压性视网膜病变、视网膜动脉硬化、糖尿病视网膜病变等。较常见的眼病主要是白内障、黄斑前膜、病理性近视、青光眼等。白内障、高血压性视网膜病变、糖尿病视网膜病变、黄斑前膜、青光眼等眼病在50岁以上者更常见。高血压性视网膜病变在黄河以北地区的患者中更常见。(眼科,2015,24:220-225)

关键词: 远程眼科学, 筛查

Abstract:

Objective To study the constituent ratio of disease?in ocular fundus image reading of teleophthalmology. Design Retrospective case series. Participants The same ophthalmologist continuous in Beijing Tongren Hospital reading center of teleophthalmology during March to April in 2015, evaluated patient data 1192 cases, from 54 Chinese different grassroots hospitals. Methods The report data of evaluation were exported with Daheng Prust remote reading database software, and analyzed with Excel and SPSS software. If the diagnosis of the screening was not explicit, another ophthalmologist would check the diagnosis data in the database. The disease constituent ratios in different age groups (<50 and≥ 50) and in different geographic location( the northern and southern of the Yellow River ) were compared. Main Outcome Measures The disease constituent ratio. Result In the all 1192 cases, ametropia was in 408 cases (34.3%), cataract in 273 cases (22.9%), hypertensive retinopathy in 228 cases (19.1%), normal fundus in 160 cases (13.4%), retinal arteriosclerosis in 114 cases (9.6%), diabetic retinopathy in 85 cases (7.1%), macular and the posterior proretinal membrane in 57 cases (4.8%), pathological myopia in 47 cases (3.9%), glaucoma in 29 cases (2.4%), suspected glaucoma in 27 cases (2.3%), branch retinal vein occlusion in 25 cases (2.1%), diabetic macular edema in 21 cases (1.8%), age-related macular degeneration in 21 cases (1.8%). The disease diagnosis in less than 50 year group (366 cases) and in 50 years and over group (826 cases) respectively were ametropia in 168 cases (45.9%) and in 240 cases (29.1%); normal fundus in 106 cases (29.0%) and in 54 cases (6.5%); cataract in 19 cases (5.2%) and in 254 cases (30.8%); hypertensive retinopathy in 23 cases (6.3%) and in 205 cases (24.8%); retinal arteriosclerosis in 4 cases (1.1%) and in 109 cases (13.2); diabetic retinopathy in 10 cases (2.7%) and in 75 cases (9.1%); macular and the posterior retinal membrane in 0 cases (0%) and in 57 cases (6.9%); glaucoma in 4 cases (1.1%) and in 25 cases (3.0%); branch retinal vein occlusion in 2 cases (0.5%) and in 23 cases (2.8%); age-related macular degeneration in 0 cases (0%) and in 21 cases (2.5%). The disease constitution in the northern of the Yellow River group (796 cases) and in the southern of Yellow River (396 cases) group were hypertensive retinopathy in 172 cases (21.6%) and in 56 cases (14.1%); glaucoma in 12 cases (1.5%) and in 17 cases (4.3%); posterior vitreous detachment in 13 cases (1.6%) and in 14 cases (3.5%). Conclusion In present teleophthalmology screening based on fundus images reading, 1/3 of the patients belong to the ametropia. The ocular manifestations of the common systemic eye diseases are hypertensive retinopathy, retinal arteriosclerosis, and diabetic retinopathy, etc. The common eye diseases were mainly cataract, macular membrane, pathological myopia, glaucoma, etc. Cataract, hypertensive retinopathy, diabetic retinopathy, macular membrane, glaucoma are more common in aged 50 years or more. Hypertensive retinopathy is more common in patients of the northern of the Yellow River. (Ophthalmol CHN, 2015, 24: 220-225)

Key words: teleophthalmology, screening