免散瞳眼底照相在民航飞行员体检中的应用

目的：了解飞行员眼底疾病分布情况，探讨免散瞳眼底照相在民航飞行员体检鉴定中的应用价值。方法采用免散瞳眼底照相机和直接眼底镜对招飞学生和年度体检飞行员（40岁以上）进行眼底检查。结果915人接受了两种方法检查眼底，检出眼底疾病251例。其中视网膜动脉硬化居首位（12％）；其次是眼底先天性异常（5.8％）。在未散瞳状态下，眼底照相方法与传统的直接检眼镜检查结果符合率为94.75％，Kappa值为0.86，但优于后者。与直接检眼镜检查比较，眼底照相新发现眼底病例30例。对312名招飞学生散瞳后检查眼底，直接检眼镜检查新发现疾病21例。眼底照相方法与传统的直接检眼镜检查结果符合率为94.87％， Kappa值为0.87，后者更有优势。结论免散瞳眼底照相是一项操作简便、记录客观的方法，适合在飞行员年度体检和心脑血管事件危险因子预测中的应用。招飞体检是选拔性体检，为保证体检质量，散瞳后应以直接检眼镜为主，眼底照相辅助诊断。

A Preliminary Study on Using Non -mydriatic Fundus Camera for Poliots Annual Examination

Objective To investigate the ocular found disease in pilots and explore the role of ocular fundus camera in clinical aviation medicine.Methods The ocular fundus of pilots aged over 40 and prepared pilot youth were exam-ined by direct ophthalmoloscope and non-mydriatic fundus camera during annual physical examination.Results 915 members were examined by both methods.In latter,251subjects were found to have abnormal ocular fundus.The most ab-normal was retinal arteriosclerosis and was about 12%.The secondary abnormal was congential anomaly of ocular fundus was about 5.8%.In natural pupil size, The accordant rate of two methods was 94.75% and Kappa value was 0.86.Compared with direct ophthalmoscope method, additional 30 abnormal ocular fundus cases were found by non -mydriatic fundus camera.312students with pharmacologically dilates pupils were examined by direct ophthalmoloscope and non-mydriatic fundus camera,additional 21 abnormal ocular fundus cases were found by direct ophthalmoloscope.The accordant rate of two methods was 94.87% and Kappa value was 0.87, direct ophthalmoloscope has more advan-tage.Conclusions Non-mydriatic fundus camera technique is a convenient and objective method to record abnormal retinal images.It is fit for medical physical examination and cardiovascular and cerebrovascular events risk factor predic-tion in aviation medicine.Ensuring the quality of physical examination, direct ophthalmoloscope also play an important role.