Department of Ophthalmology, Emory University, Atlanta, Georgia2Department of Neurology, Emory University, Atlanta, Georgia3Department of Epidemiology, Emory University, Atlanta, Georgia.
Department of Ophthalmology, Emory University, Atlanta, Georgia2Department of Neurology, Emory University, Atlanta, Georgia.
JAMA Neurol. 2015 Apr;72(4):455-9. doi: 10.1001/jamaneurol.2014.4053.
The ocular fundus examination is infrequently and poorly performed in clinical settings, placing patients at risk for missed and delayed diagnosis of vision- and life-threatening neurologic disease.
To review the importance of ocular fundus examination, the limitations of direct ophthalmoscopy, and the relative merits of nonmydriatic ocular fundus photography in emergency neurologic diagnosis.
PubMed queries were reviewed for articles of relevance to this review. Queries included relevant combinations of the search terms ophthalmoscopy, nonmydriatic, neurology, and emergency, including variant spellings and endings.
Nonmydriatic ocular fundus photography is more sensitive than direct ophthalmoscopy in several settings. It can be feasibly performed in emergency departments and has substantial promise in improving neurologic diagnosis, particularly headache and cerebrovascular disease.
Nonmydriatic ocular fundus photography has notable advantages over direct ophthalmoscopy that likely outweigh its associated costs. More widespread deployment and integration into neurologic practice is expected to improve diagnosis and patient outcomes.
在临床环境中，眼底检查的频率较低且效果不佳，使患者面临视力和危及生命的神经疾病漏诊和延误诊断的风险。
回顾眼底检查的重要性、直接检眼镜检查的局限性以及非散瞳眼底摄影在急诊神经诊断中的相对优势。
对与本次综述相关的文章进行了 PubMed 查询。查询包括了眼底检查、非散瞳、神经病学和急诊等相关搜索词的组合，包括变体拼写和结尾。
在几种情况下，非散瞳眼底摄影比直接检眼镜检查更敏感。它可以在急诊科中可行地进行，并且在改善神经诊断方面具有很大的潜力，特别是头痛和脑血管疾病。
非散瞳眼底摄影相对于直接检眼镜检查具有显著优势，其相关成本可能超过优势。预计更广泛的部署和整合到神经科实践中将改善诊断和患者预后。
