Scanlon P H, Foy C, Chen F K
Gloucestershire Eye Unit, Cheltenham General Hospital, Sandford Road, Cheltenham GL53 7AN, UK.
Br J Ophthalmol. 2008 Jun;92(6):775-8. doi: 10.1136/bjo.2007.128561. Epub 2008 Mar 20.
To evaluate the relationship between best corrected visual acuity (BCVA), age, type of diabetes, sight-threatening diabetic retinopathy (STDR) and ocular co-morbidity.
1549 randomly selected people with diabetes mellitus (DM) from a countywide digital photographic screening programme had standardised logarithm of minimum angle of resolution (logMAR) BCVA measurement, followed by slit-lamp biomicroscopy examination by an experienced ophthalmologist.
Subnormal vision (logMAR > or =0.3, Snellen < or =6/12) and blindness (logMAR >1.3, Snellen <3/60) in the better-seeing eye were found in 9.0% and 0.45%. The sensitivity, specificity and positive and negative predictive values of using subnormal vision to screen for STDR in an individual eye were 33.4%, 85.9%, 18.6% and 93.0%, respectively. Important contributory causes of moderate visual loss (logMAR 0.50 to 0.98, Snellen 6/18 or worse but better than 6/60) and of Acuity Blindness (logMAR > or =1.0, Snellen 6/60 or worse) in an individual eye were lenticular opacity (including capsular opacification) 49%, macular degeneration (including myopic degeneration) 29%, diabetic maculopathy 15%, other media causes (including corneal opacity) 13% and amblyopia 10%.
The majority of visual loss in a population with diabetes is due to causes other than diabetic retinopathy. BCVA alone is not a reliable criterion in predicting STDR.
评估最佳矫正视力（BCVA）、年龄、糖尿病类型、威胁视力的糖尿病视网膜病变（STDR）与眼部合并症之间的关系。
从全县数码摄影筛查项目中随机选取1549例糖尿病患者，测量其标准化最小分辨角对数（logMAR）BCVA，然后由经验丰富的眼科医生进行裂隙灯生物显微镜检查。
视力较好的眼睛中，视力低于正常（logMAR≥0.3，Snellen≤6/12）和失明（logMAR＞1.3，Snellen＜3/60）的比例分别为9.0%和0.45%。单眼使用低于正常视力筛查STDR的敏感度、特异度、阳性预测值和阴性预测值分别为33.4%、85.9%、18.6%和93.0%。单眼中度视力丧失（logMAR 0.50至0.98，Snellen 6/18或更差但优于6/60）和视力失明（logMAR≥1.0，Snellen 6/60或更差）的重要原因包括晶状体混浊（包括囊膜混浊）49%、黄斑变性（包括近视性变性）29%、糖尿病性黄斑病变15%、其他介质原因（包括角膜混浊）13%和弱视10%。
糖尿病患者群体中的大多数视力丧失是由糖尿病视网膜病变以外的原因导致的。仅BCVA并不是预测STDR的可靠标准。
