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目的:探讨黄斑光学相干断层扫描（optical coherence tomography，OCT）在武汉市武昌区中小学教师眼部体检中的应用价值。方法:选取2018年9至12月在武汉大学人民医院健康管理中心体检的武昌区中小学教师共3 495人，其中男1 130人，女2 365人，年龄22~93岁，入选对象按年龄分为3组，均完成视力、裂隙灯、直接检眼镜及黄斑部OCT的检查。采用卡方检验分析检出率前十位眼病及阳性发现在不同年龄段各组间的差异，分析OCT检查与直接检眼镜检查对黄斑病变检出率的差异。结果:眼科异常检出率为70.76％（2 473/3 495）。<40岁组检出异常者551人， 40～64岁组检出异常者775人，≥65岁组检出异常者1 147人。其中屈光不正、白内障、黄斑病变、白内障术后、病理性近视眼底改变、翼状胬肉、倒睫、视网膜动脉硬化、杯盘比异常在<40岁年龄组、40～64岁年龄组及≥65岁年龄3组间检出率差异均有统计学意义（χn 2=100.24、1 037.23、507.61、232.50、14.46、54.92、21.48、84.24、17.73，n P均0.05）。OCT（12.60%）对黄斑病变的检出率高于直接检眼镜（9.41%）（χn 2=36.357，n P<0.05），对黄斑病变中黄斑前膜、黄斑变性、病理性近视视网膜脉络膜病变和黄斑劈裂OCT检查的检出率高于直接检眼镜，差异具有统计学意义（χn 2=10.065、4.932、19.836、12.010，n P均<0.05）。n 结论:中小学教师不同年龄段眼部疾病谱分布存在差异，可根据该特点制定健康宣教和眼部体检，有利于眼病的早预防和早治疗。OCT对黄斑部疾病的体检筛查有重要应用价值。“,”Objective:To explore the value of applying optical coherence tomography (OCT) in the physical examination of the eyes of primary and secondary school teachers in Wuchang District, Wuhan.Methods:A total of 3,495 teachers in primary and secondary schools in Wuchang District, who were examined at Physical Examination Center of Renmin Hospital of Wuhan University from September to December, 2018, were enrolled, including 1 130 men and 2 365 women, aged 22-93 years. All enrolled subjects underwent visual acuity assessment, slit lamp examination, direct ophthalmoscopy, and OCT of the macula. The chi-square test was used to analyze differences between different age groups for the ten most common eye diseases and positive findings, as well as the difference in the detection rate of macular disease between OCT and direct ophthalmoscopy.Results:The detection rate of eye diseases was 70.76% (2 473/3 495 people) in this study; 551 people <40 years old, 775 people aged 40-64 years old, and 1 147 aged ≥65 years old had abnormalities. There were significant differences in the detection rates of ametropia, cataract, maculopathy, postoperative cataract, pathological myopic fundus change, pterygium, trichiasis, retinal arteriosclerosis, and cup disk ratio abnormality between the three groups (χ2=100.24, 1037.23, 507.61, 232.50, 14.46, 54.92, 21.48, 84.24, 17.73, respectively, all n P0.05). The detection rate of OCT for maculopathy was higher than that for direct ophthalmoscopy (χ2=36.357, n P<0.05), and the detection rate of OCT for macular anterior membrane, macular degeneration, pathological myopia, retinochoroidopathy, and macular split was higher than that for direct ophthalmoscope; the difference was statistically significant (χ2=10.065, 4.932, 19.836, 12.010, respectively, all n P<0.05).n Conclusion:Primary and secondary school teachers have different distributions of eye diseases depending on their age group. Health education and physical examination of the eye can be provided according to the age of the teacher, which is conducive to early prevention and treatment of eye diseases. OCT has important application value in physical examination and the screening of macular diseases.