探讨获得性免疫缺陷综合征（AIDS）患者眼底病早期筛查中免散瞳超广角激光扫描检眼镜的应用优势。

利用免散瞳超广角激光扫描检眼镜和常规眼底检测技术筛查2019年3月至2020年3月于首都医科大学附属北京地坛医院眼科就诊的80例并发眼底病变AIDS患者，采集免散瞳眼底图像后由另一位眼科医师（副主任医师）检查眼底，记录两种检査方法所观察每例患者眼底症状、病变类型及位置。若检査结果不一致，由眼底病专家（主任医师）结合眼底筛查等多种检查手段判定。借助非参数统计Kappa值和打分评定方法分别判定检查方法的一致性。

入组80例伴有眼底病AIDS患者中，18例（22.5%）患者为巨细胞病毒性视网膜炎，16例（20%）患者为继发视网膜脱离，24例（30%）患者为AIDS视网膜病变，22例（27.5%）患者为视神经病变。利用免散瞳超广角激光扫描检眼镜和常规眼底检测技术方法对巨细胞病毒性视网膜炎检出结果一致性完全一致（Kappa值= 1），对继发视网膜脱离、获得性免疫缺陷综合征视网膜病变和视神经病变检出一致性良好（Kappa值= 0.850、0.886、0.872）；与常规眼底检测技术比，免散瞳超广角激光扫描检眼镜检查无需散瞳，不接触患者，且拍摄快捷。

免散瞳超广角激光扫描检眼镜、常规眼底检测技术两种检查方法的检查结果一致性良好，免散瞳超广角激光扫描检眼镜适用于多种眼底疾病的筛查、诊断和预后评估，提高诊断和治疗效率，对AIDS患者眼底病早期筛查、早期治疗具有重要意义。

To investigate the application advantages of ultra-wide-field laser scanning ophthalmoscope in the early screening of acquired immune deficiency syndrome (AIDS) fundus diseases.

From March 2019 to March 2020, 80 patients with AIDS and complicated with fundus diseases who were treated in the ophthalmology department of Beijing Ditan Hospital, Capital Medical University were treated with ultra-wide-angle non-mydriatic laser scanning ophthalmoscope and conventional fundus detection techniques. Screening, fundus images were collected, the fundus was examined by an ophthalmologist (deputy chief physician), and the fundus symptoms, lesion type and location of each patient were recorded under the two examination methods. If the test results are inconsistent, it will be judged by the fundus specialist (chief physician). The consistency and dominance of the inspection methods were judged by means of non-parametric statistical Kappa value and scoring method, respectively.

Among the 80 AIDS patients with fundus disease, 18 (22.5%) cases were with CMV retinitis, 16 (20%) cases with secondary retinal detachment, 24 (30%) cases with AIDS retinopathy, and 22 (27.5%) cases with optic neuropathy. The detection results of cytomegalovirus retinitis detected by non-dilated pupil ultra-wide angle laser scanning ophthalmoscope and conventional fundus detection techniques were completely consistent (Kappa value = 1), while good agreement was found for secondary retinal detachment, acquired immunodeficiency syndrome retinopathy and optic neuropathy (Kappa value = 0.850, 0.886, 0.872). Compared with the conventional fundus detection technique, the non-dilated pupil ultra-wide angle laser scanning ophthalmoscopy examination does not need the dilated pupil, does not contact the patients, and the shooting is fast.

The results of the ultra-wide angle laser scanning ophthalmoscopy and the conventional fundus detection technique were well consistent, non-dispersing pupil ultra-wide-angle laser scanning ophthalmoscopy is suitable for the screening, diagnosis, and prognostic evaluation of multiple fundus diseases, improving the efficiency of diagnosis and treatment, it is of important significance for the early screening and early treatment of fundus disease in patients with AIDS.