瓦努阿图卢甘维尔2型糖尿病登记患者中糖尿病视网膜病变的患病率、严重程度、相关危险因素及视力丧失情况
The prevalence and severity of diabetic retinopathy, associated risk factors and vision loss in patients registered with type 2 diabetes in Luganville, Vanuatu.
作者信息
Smith Tasanee S T, Szetu John, Bourne Rupert R A
机构信息
Department of Medicine, Imperial College Faculty of Medicine, Hammersmith Hospital, London, UK.
出版信息
Br J Ophthalmol. 2007 Apr;91(4):415-9. doi: 10.1136/bjo.2006.104174. Epub 2006 Oct 31.
AIM
To determine the prevalence and severity of diabetic retinopathy in patients with type 2 diabetes in Luganville, the second largest town in Vanuatu. Additionally, to investigate risk factors for retinopathy and the effect of retinopathy on visual acuity (VA) within this group.
METHOD
All 83 registered patients with type 2 diabetes in Luganville, a town of 13 121 people, were invited for an interview and anthropometric measurements. A questionnaire including assessment of hypertension and glycaemic control, which are known risk factors for diabetic retinopathy, was administered. This sample accounted for approximately 1.07% of Luganville's adult population. Presenting VA was measured. The retina was photographed with a non-mydriatic fundus camera and images later independently graded for the extent of retinopathy.
RESULTS
68 (82%) of the 83 patients attended. The mean (SD) age was 54 (11) years and 31 (46%) were male. Diabetic retinopathy was present in 36 (52.9%) of the sample. Sight-threatening retinopathy requiring urgent referral was present in 15 (22.1%) patients. Presenting VA was worse than 6/12 in the better eye in n = 32 (47%) and in up to half of these cases the principal cause was retinopathy. In addition, four people had uniocular blindness resulting from diabetes. The mean body mass index was lower in those patients with diabetes with retinopathy than in those without (p = 0.010), but there were no other significant differences between the two groups and, specifically, no difference in the frequency of retinopathy risk factors. 42 (61.8%) patients had hypertension (>or=135/85 mm Hg) or were taking antihypertensive therapy.
CONCLUSIONS
The prevalence of registered patients with diabetes in Luganville's adult population was 1.07%. Diabetic retinopathy was highly prevalent in the sample (in 36, 52.9%), and in 15 (22.1%) there was a significant threat to sight, with up to 25% of the sample possibly already affected by decreased VA or blindness resulting from diabetes-related eye disease. Retinopathy risk factors were also prevalent. A diabetes screening programme with baseline ophthalmic assessment and follow-up are urgently needed to enable timely intervention and treatment.
目的
确定瓦努阿图第二大城镇卢甘维尔2型糖尿病患者糖尿病视网膜病变的患病率和严重程度。此外，调查该组患者视网膜病变的危险因素以及视网膜病变对视力（VA）的影响。
方法
邀请卢甘维尔镇所有83名登记在册的2型糖尿病患者（该镇有13121人）进行访谈和人体测量。发放一份问卷，内容包括对高血压和血糖控制情况的评估，这些都是已知的糖尿病视网膜病变危险因素。该样本约占卢甘维尔成年人口的1.07%。测量就诊时的视力。用免散瞳眼底相机拍摄视网膜，随后对图像进行独立分级以确定视网膜病变程度。
结果
83名患者中有68名（82%）前来就诊。平均（标准差）年龄为54（11）岁，男性31名（46%）。样本中有36名（52.9%）存在糖尿病视网膜病变。15名（22.1%）患者存在需要紧急转诊的威胁视力的视网膜病变。在n = 32名（47%）患者中，较好眼的就诊视力低于6/12，其中多达一半病例的主要病因是视网膜病变。此外，有4人因糖尿病导致单眼失明。糖尿病伴视网膜病变患者的平均体重指数低于无视网膜病变患者（p = 0.010），但两组之间无其他显著差异，尤其是视网膜病变危险因素的频率无差异。42名（61.8%）患者患有高血压（≥135/85 mmHg）或正在接受抗高血压治疗。
结论
卢甘维尔成年人口中登记的糖尿病患者患病率为1.07%。样本中糖尿病视网膜病变非常普遍（36名，52.9%），15名（22.1%）存在对视力的严重威胁，多达25%的样本可能已经受到糖尿病相关眼病导致的视力下降或失明的影响。视网膜病变危险因素也很普遍。迫切需要开展一项包括基线眼科评估和随访的糖尿病筛查计划，以便及时进行干预和治疗。
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