远程眼科眼底像阅片诊断应注意的问题

doi:10.13281/j.cnki.issn.1004-4469.2014.04.001

眼科 ›› 2104, Vol. 23 ›› Issue (4): 217-220.doi: 10.13281/j.cnki.issn.1004-4469.2014.04.001

远程眼科眼底像阅片诊断应注意的问题

李建军张莉彭晓燕

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

收稿日期:2014-06-19 出版日期:2014-07-25 发布日期:2014-07-22
通讯作者: 彭晓燕，Email：drpengxy@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）

Some issues of diagnosis based on ocular fundus image reading in teleophthalmology

LI Jian-jun, ZHANG Li, PENG Xiao-yan.

Beijing Institute of Ophthalmology, Beijing Tongren Eye Centre, Beijing Tongren Hospital, Capital Medical University, Beijing 100005, China.

Received:2014-06-19 Online:2014-07-25 Published:2014-07-22
Contact: PENG Xiao-yan，Email：drpengxy@163.com

摘要/Abstract

摘要： 为进一步提高远程眼科医疗服务质量，对远程眼科眼底像阅片诊断的认识需要认真梳理。眼底照相机采集图像的质量是决定远程眼科眼底像阅片诊断质量的基础。眼底像位置正确、图像清晰、对焦准确是基本要求。单张眼底像对多种常见致盲性眼病如青光眼、糖尿病视网膜病变、年龄相关性黄斑变性等的筛查及诊断起着极其重要的作用，但其不能发现周边眼底病变，也不能判定病变的立体特性，在缺乏其他临床资料支持的情况下，存在一定的误诊和漏诊风险。基于眼底像的远程会诊眼底病的能力目前仍存在挑战，需制定我国远程眼科会诊服务的分级标准，并对此进行客观而全面的评价。书写眼底像阅片报告时，要重视患者病史及主诉，着重描述有鉴别诊断意义的眼底像体征，慎重进行诊断，多提供一些处理建议。（眼科， 2014， 23： 217-220）

关键词: , 远程医疗, 远程眼科, 筛查, 诊断, 阅片

Abstract: It is important to sort out the understanding of teleophthalmolgy fundus photography diagnosis to improve the quality of distance ophthalmic medical service. The quality of fundus photos determines the quality of the diagnosis. The basic requirements of fundus photos are correct position and accurate focusing and clear image. Single fundus photo plays an important role in the screening and diagnosis of common blinding diseases, such as glaucoma, diabetic retinopathy, age related macular degeneration. However, it can't find peripheral fundus lesion, also cannot determine the stereospecificity of the lesion. In the absence of other clinical data, there is a risk of misdiagnosis and missed diagnosis. The remote consultation on fundus diseases based on fundus photos is facing the challenges, so it is significant to set classification standard of remote consultation on fundus diseases, and evaluate it objectively and comprehensively. When writing the report of image reading, it is important to pay attention to the medical history and complaint, emphatically describe fundus signs with differential diagnosis significance, make a diagnosis carefully and provide treatment suggestion more. (Ophthalmol CHN, 2014, 23: 217-220)

Key words: telemedicine, teleophthalmology, screening, diagnosis, fundus image reading

李建军张莉彭晓燕. 远程眼科眼底像阅片诊断应注意的问题[J]. 眼科, 2104, 23(4): 217-220.

LI Jian-jun, ZHANG Li, PENG Xiao-yan. . Some issues of diagnosis based on ocular fundus image reading in teleophthalmology[J]. Ophthalmology in China, 2104, 23(4): 217-220.

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远程眼科眼底像阅片诊断应注意的问题

Some issues of diagnosis based on ocular fundus image reading in teleophthalmology

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