Siegel B S, Thompson A K, Yolton D P, Reinke A R, Yolton R L
Pacific University College of Optometry, Forest Grove, OR 97116.
J Am Optom Assoc. 1990 Jan;61(1):25-34.
To compare the quality of fundus evaluations conducted with natural and dilated pupils, 500 typical adult subjects, divided into five age categories, were examined using both techniques. Direct and monocular indirect ophthalmoscopes were used with the natural pupils; direct and binocular indirect scopes were used for the dilated examinations. Retinal anomalies were classified on the basis of posterior pole or peripheral location and whether the anomalies would require significant action by the doctor. Of the 32 posterior pole anomalies which required action, 38% were missed during the natural pupil examination; 51% of the anomalies not requiring immediate action were also missed. These miss rates, along with the 287 anomalies found in the periphery (20 of which required immediate action), suggest that dilation should be strongly considered for all patients so as to optimize the probability of detecting fundus anomalies.
为比较在自然瞳孔和散瞳情况下进行的眼底评估质量，对500名典型成年受试者进行了两种技术的检查，这些受试者被分为五个年龄类别。自然瞳孔检查时使用直接检眼镜和单眼间接检眼镜；散瞳检查时使用直接检眼镜和双眼间接检眼镜。视网膜异常根据后极或周边位置以及这些异常是否需要医生采取重大措施进行分类。在32例需要采取措施的后极异常中，自然瞳孔检查时有38%被漏诊；在不需要立即采取措施的异常中，也有51%被漏诊。这些漏诊率，以及在外周发现的287例异常（其中20例需要立即采取措施），表明应强烈考虑对所有患者进行散瞳，以优化检测眼底异常的概率。
