眼科

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我国青光眼临床诊断方式基于微信的问卷调查

乔春艳   张慧  赵爱萍  曹凯  杨晓晗  胡健萍  梁静  宋静  王宁利   

  1. 100730 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(乔春艳、张慧、曹凯、杨晓晗、胡健萍、 梁静、宋静、王宁利);100123北京科林利康医学研究有限公司(赵爱萍)
  • 收稿日期:2017-12-16 出版日期:2018-01-25 发布日期:2018-01-26
  • 通讯作者: 王宁利,Email:wningli@vip.163.com
  • 基金资助:

    国家自然科学基金(81570837)

The questionnaire survey based on WeChat on glaucoma diagnotic methods in China

QIAO Chun-yan1, ZHANG Hui1, ZHAO Ai-ping2, CAO Kai1, YANG Xiao-han1, HU Jian-ping1, LIANG Jing1, SONG Jing1, WANG Ning-li1.   

  1. 1. Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Key Laboratory of Ophthalmology and  Visual Sciences, Beijing 100730, China; 2. Beijing Clinical Service Center, Beijing 100123, China
  • Received:2017-12-16 Online:2018-01-25 Published:2018-01-26
  • Contact: WANG Ning-li , Email: wningli@vip.163.com

摘要:

目的 了解我国青光眼诊断方式及相关设备使用的现状。设计 横断面研究。研究对象 可以网络联系的中国大陆地区眼科医生。方法 根据研究目的自行设计问卷,使用“问卷星”设计问卷链接,通过微信直接发送或二次转发到全国或省市地区的微信群。调查对象直接在手机填写问卷,一个手机号码只能提交一次问卷。使用SAS 9.4软件进行统计分析,关联分析采用卡方检验。主要指标 Goldmann眼压计使用率、前房角、眼底、视野的不同评估方法的使用比率、不同房角镜分类方法的使用比率。结果 共收到除了港澳台西藏以外的全国28个省级行政区的1111份问卷。48.48%所在医院有青光眼专业组,青光眼专家和专科医生占20.62%。常规使用Goldmann眼压计的占25.29%,42.94%因医院无Glodmann眼压计而无法常规使用。最常用的房角检查法是房角镜(69.49%)和UBM(17.55%)。使用房角镜频率75%~100%的被调查者仅为35.64%,29.26%的被调查者房角镜使用频率低于25%。最常用的房角分级法是Scheie法(74.17%)。最常用的眼底检查仪器是直接检眼镜(39.97%),其次是前置镜(29.16%),眼底照相仅占11.61%。25.74%的被调查者用眼底照相的频率低于25%。最常用的视野检查为Humphrey视野计(45.00%)。青光眼专家及专科医生使用房角镜、眼底照相及Humphrey视野计的频率显著高于其他医生。结论  我国青光眼诊断实践中,未能广泛采用Goldmann眼压测量,房角镜检查和眼底照相技术使用率比较低。我国青光眼诊断规范化与国际存在差距,需进一步加强培训、推广规范化流程,以减少我国与国际诊疗水平间的差异。(眼科, 2018, 27: 9-15)

关键词: 青光眼, 问卷调查, Goldmann眼压, 房角镜, 眼底照相

Abstract:

 Objective To obtain the national real situation of glaucoma dignosis and related instrument usage in China. Design Cross-sectional survey. Participants Ophthalmologists who were internet available throughout the mainland. Method The questionnaire and link were designed and sent by WeChat directly. The respondents filled out the questionnaire directly on the mobile phone, and a mobile phone number can only be submitted once. The data analysis was conducted by SAS 9.4, the association analysis used chi square test. Main Outcome Mearsures Utilization rate of  Goldmann tonometer. The ratio of different instruments used to assess the angle of anterior chamber, fundus, and visual field. The utilization rate of different methods for angle classification. Results A total of 1111 questionnaires were received from 28 provincial administrative regions, among which 20.62% were glaucoma specialists and attending doctors, and 48.48% had glaucoma department in their hospitals. Only 25.29% of them used Goldmann applanation tonometer (GAT) as the routine IOP measurement, and 42.94% didn’t regularely use GAT because of the lack of the device. The most favorite methods in checking chamber angle was gonioscopy (69.49%) , followed by UBM (17.55%). Only 35.64% of the respondents whose frequency of utilization of gonioscopy was between 75%~100%, and 29.26% of the respondents whose frequency of utilization of gonioscopy was less than 25%. Scheie classification was the main (74.17%) grading system for gonioscopy. Direct ophthalmoscope was the most common fundus examination instruments (39.97%), followed by indirect slit-lamp lens (29.16%), and the fundus camera was only 11.61%. 25.74% of those being surveyed had a frequency of utilization of fundus camera less than 25%. In visual field test, Humphrey perimetry (45.00%) was most commonly applied. Glaucoma specialists and attending doctors used gonioscope, fundus cameras and Humphrey perimetry significantly more often than others. Conclusion In the current practice of glaucoma diagnosis in China, GAT measurement has not been widely used. The frequency of utilization of gonioscope and fundus camera was low. There is a gap between real clinical situation and international standards, and the process of training and promotion standalization needs to be strengthened to reduce the difference between China and the international level in glaucoma diagnosis guidelines. (Ophthalmology, 2018, 27: 9-15)

Key words: glaucoma, questionnaires, Goldmann tonometer, gonioscope, fundus camera