Narendran V, John R K, Raghuram A, Ravindran R D, Nirmalan P K, Thulasiraj R D
Aravind Medical Research Foundation, Aravind Eye Care System, Tamil Nadu, India.
Br J Ophthalmol. 2002 Sep;86(9):1014-8. doi: 10.1136/bjo.86.9.1014.
To estimate the prevalence of diabetic retinopathy among self reported diabetics in a population of southern India.
A cross sectional sample of subjects aged 50 years and older was selected using a cluster sampling technique from Palakkad district of Kerala state. Eligible subjects were identified through a door to door survey. Ocular examinations including visual acuity and anterior and posterior segment examinations were performed at preselected sites within clusters. History of diabetes was elicited, and height, weight, and blood pressure were measured for all subjects.
Among the 5212 examined people (92% response rate), 68 (26.2%) of 260 people with self reported history of diabetes had diabetic retinopathy. The age-sex adjusted prevalence of diabetes among people aged 50 years and older was 5.1% (95% CI 3.9, 6.3, deff 4.33) and of diabetic retinopathy among the diabetics was 26.8% (95% CI: 19.2, 34.4, deff 1.99). Non-proliferative diabetic retinopathy (94.1%) was the most common form of retinopathy seen. Two eyes were blind (presenting vision <6/60) as a result of retinopathy.
Preventive strategies have to be evolved to ensure that blindness due to diabetic retinopathy does not become a public health problem in India. Further studies are required to understand the risk factors for retinopathy and vision loss in this population.
评估印度南部人群中自我报告的糖尿病患者糖尿病视网膜病变的患病率。
采用整群抽样技术,从喀拉拉邦帕拉卡德区选取50岁及以上的横断面样本。通过挨家挨户的调查确定符合条件的受试者。在各群组内预先选定的地点进行包括视力以及眼前节和眼后节检查在内的眼部检查。询问所有受试者的糖尿病病史,并测量身高、体重和血压。
在5212名接受检查的人群(应答率为92%)中,260名自我报告有糖尿病病史的人群中有68名(26.2%)患有糖尿病视网膜病变。50岁及以上人群中经年龄 - 性别调整后的糖尿病患病率为5.1%(95%可信区间3.9, 6.3,设计效应4.33),糖尿病患者中糖尿病视网膜病变的患病率为26.8%(95%可信区间:19.2, 34.4,设计效应1.99)。非增殖性糖尿病视网膜病变(94.1%)是最常见的视网膜病变形式。有两只眼睛因视网膜病变而失明(视力<6/60)。
必须制定预防策略,以确保糖尿病视网膜病变导致的失明不会在印度成为一个公共卫生问题。需要进一步研究以了解该人群中视网膜病变和视力丧失的危险因素。