Analysis of 449 fundus examination results detected by three-mirror lens during civil aviator recruitment′s physical examination
10.3760/cma.j.cn113854-20200723-00107
- VernacularTitle:民航招飞体检中449例眼底三面镜检查结果分析
- Author:
Yirong WANG
1
;
Huan LIU
;
Furong SHEN
;
Yana QI
Author Information
1. 中国民用航空飞行学院医院，四川省广汉 618307
- Publication Type:Journal Article
- Keywords:
Ophthalmoscopy;
Diagnostic techniques, ophthalmological;
Fundus oculi;
Visual perception;
Physical examination;
Personnel selection;
Three-mirror lens
- From:
Chinese Journal of Aerospace Medicine
2021;32(3):134-141
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the necessity and practical significance of fundus examination by three-mirror lens by analyzing the fundus examination results of students with suspected fundus lesions in physical examination of civil aviation recruitment.Methods:Data of fundus examination detected by three-mirror lens of students with suspected fundus lesions were collected among 1 808 students in physical examination of civil aviation recruitment from November 2017 to December 2019. Descriptive analysis were used to present the frequency and proportion of various fundus lesions, and the consistency between the results of direct ophthalmoscope and three-mirror lens was tested and the Kappa value was calculated. Chi-square test or Fisher exact probability method were used to analyze the characteristics of fundus lesions distributed across eye types, diopters and lesion locations (divided into upper temporal, lower temporal, upper nasal, and lower nasal by quadrants, or posterior polar, equatorial and peripheral parts by concentric circle).Results:A total of 449 students (898 eyes) with suspected fundus lesions detected by direct ophthalmoscope, of which 434 students were diagnosed with any kind of fundus lesions. The diagnosis rate was 96.66% (434/449); the detection rate of suspected fundus lesions was 24.83% (449/1 808); the detection rate of fundus lesions was 24.00% (434/1 808). Among 898 eyes of 449 suspected students, those with frost-like degeneration (233 eyes, 25.95%), cystic degeneration (170 eyes, 18.93%) and paving stone degeneration (234 eyes, 26.06%) were common. There were 70 eyes and 13 eyes detected with retinal holes and retinal detachment, accounting for 7.80% and 1.45% of the total eyes, respectively. Congenital hypertrophy of retinal pigmented epithelium ophthalmoscope and three-mirror examination showed poor consistency in the detection results of congenital hypertrophy of retinal pigment epithelium, retinal detachment, and retinal hole (Kappa values were 0.164, 0.349 and 0.535, respectively), and direct ophthalmoscope was inclined to miss diagnosis. The detection rate of fundus lesions in the right eye was higher than that in the left eye, with a high incidence in the upper temporal, followed by the lower temporal, and most fundus lesions tend to occur in the peripheral site.Conclusions:Fundus examination by three-mirror lens could supplement the deficiency of direct ophthalmoscope in screening fundus lesions, especially in detecting retinal detachment and retinal hole. It is worth to be widely promoted and incorporated into the operating standards of ophthalmic physical examination in aviation physical examination. It is suggested to use direct ophthalmoscope for initial examination to predispose the fundus lesions according to the distribution characteristics and the site of the lesions. In case of the type and site of fundus lesions cannot be accurately judged, the confirmation, classification and follow-up should be determined by the result of three-mirror lens examination.
