北京市社区青光眼筛查模式初步研究

目的探讨社区青光眼筛查模式的可行性。设计人群横断面研究。研究对象北京市东城区社区≥50岁居民6886人。方法2007年9月～2008年4月在北京市东城区18个社区进行青光眼为主的眼病筛查。由社区工作人员组织，在进行视力检查及简单问卷后，在社区对所有受试者进行非散瞳眼底数码照相。眼底图像不清楚者，用眼底照相机照眼前节照片。图像上传至浏览器／服务器架构的数据库，由专业人员集中阅片。可疑青光眼的诊断主要依据视乳头及视网膜神经纤维层形态学改变，并转到专科医院进一步诊治。主要指标可疑青光眼的患病率。结果发现可疑青光眼405例（5．88％），男性占38％，平均年龄（71．0±7．8）岁。50～59、60～69、70～79、80岁以上者分别占8．O％、24．O％、56．6％、11．4％。经北京同仁医院眼科检查后诊断青光眼146例，占可疑青光眼的36．05％，占筛查总人数的2．12％，其中87例（59．59％）不知道自己患有青光眼。此外，筛查出需手术治疗的白内障289例（4．20％）：糖尿病视网膜病变557例（8．09％）；其他眼病375例（5．45％）。结论以非散瞳数码眼底照相为基础的社区青光眼筛查模式是可行的。它可以实现对青光眼、糖尿病视网膜病变及白内障等多种致盲性眼病联合筛查。组织实施及人员培训是关键。

Preliminary study of glaucoma screening mode in Beijing communities

Objective To study the feasibility of glaucoma screening mode in Beijing communities. Design Population-based cross-sectional study. Participants 6886 residents of 50 years old or over in Beijing Dongcheng District. Methods We performed glaucoma screening from Sep. 2007 to Apr. 2008 in 18 communities. Community staff organized the sereenees, examined visual acuity, and performed short questionnaire. Non-mydriasis digital fundus photographs were taken in all subjects. For subjects with unclear fundus photos, anterior segment photographs were taken with a digital fundus camera. All photos were uploaded to the special B/S database in the Internet. A professional staff read centrally all photos in the photo center. The diagnosis of suspect glaucoma based on the morphological change of optic nerve head and retinal nerve fiber layer. All suspect glaucoma were forwarded to Tongren Hospital for further diagnosis and treatment. Main Outcome Measures The prevalence of suspect glaucoma. Results 405 subjects （5.88%）were recognized as glaucoma suspects, with male 38%, average age 71.0±7.8 year-old. Suspect glaucoma of 50-59, 60-69, 70-79, and 〉t80 years old were 8.0%, 24.0%, 56.6%, 11.4%, respectively. 146 subjects were confirmed as glaucoma by Beijing Tongren Hospital. It accounted for 36.05% of glaucoma suspects and 2.12% （prevalence） of screening population. In all patients with glaucoma, 87 patients （59.59%） didn＇ t know themselves suffering from glaucoma. 289 subjects（4.20%）with cataract needing surgery were detected and 557 subjects（8.09%） with diabetic retinopathy. In addition, 375 cases （5.45%） of other eye diseases were detected. Conclusion G!aucoma screening mode of 50 years old or over in Beijing communities based on non-mydriasis digital fundus photography is feasible. It can realize joint screening of some blindness-causing eye diseases such as glaucoma, diabetic retinopathy and cataract. The keys of screening arc organizing, implement and personnel training.