OCT在社区健康档案黄斑病变筛查中的应用

目的：探讨光学相干断层扫描（OCT）在社区老年人群健康档案中建立黄斑部疾病早期筛查-干预- 随访的健康管理模式的意义。方法：回顾性研究。选取2016年1月到2017年12月在华中科技大学 同济医学院附属梨园医院公共卫生科建立健康档案的中老年人群1 206人,其中男520人,女686 人,年龄50～82（58.3±5.7）岁。运用OCT对视网膜黄斑部进行检查。采用χ2 检验和多因素Logistic 回归分析进行数据分析。结果：通过OCT检出视网膜黄斑部病变216人,检出率17.91%。阳性人 群中性别差异无统计学意义（χ2 =0.166,P=0.684）。50～59岁人群OCT检出阳性率为8.48%,60～69 岁人群为18.43%,>70岁人群为27.53%,差异有统计学意义（χ2 =36.269,P<0.001）。多因素Logistic 回归分析结果显示,高血压（OR=0.272,95%CI=0.084～0.880,P=0.030）和糖尿病（OR=0.131, 95%CI=0.039～0.440,P=0.001）是引起黄斑病变的危险因素。结论：应用OCT检查视网膜黄斑部, 能早期发现视网膜黄斑部病变,进行早期干预,是防盲治盲中不可缺少的检测手段。

The Application of Optical Coherence Tomography in Macular Lesion Screenings from Community Health Records

Objective: To explore the significance of optical coherence tomography (OCT) in the early screening, intervention and follow-up of macular diseases in middle-aged and elderly people listed in the community health records. Methods: This was a retrospective study. From January 2016 to December 2017, 1 206 middle-aged and elderly people were selected from the Public Health Department of Liyuan Hospital, Tongji Medical College, Huazhong University of Science and Technology, including 520 males and 686 females, aged 50-82 years, with an average age of 58.3±5.7 years. The macular area of the eye was examined by OCT. The data were analyzed by a χ2 test and multivariate logistic regression analysis. Results: The coincidence rate of macular diseases was 17.91%. There was no significant difference between males and females in the OCT-positive population (χ2 =0.166, P=0.684). The positive rate of OCT was 8.48% in people aged 50-59, 18.43% in people aged 60-69 and 27.53% in people over 70 years of age. The differences were statistically significant (χ2 =36.269, P<0.001). Hypertension (OR=0.272, 95%CI=0.084-0.880, P=0.030) and diabetes (OR=0.131, 95%CI=0.039-0.440, P=0.001) were risk factors for macular disease. Conclusions: OCT is an indispensable method in preventing blindness since macular disease can be detected early and result in early intervention.