Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Republic of Singapore.
Ophthalmology. 2010 Mar;117(3):524-30. doi: 10.1016/j.ophtha.2009.07.044. Epub 2010 Jan 19.
Eyes with myopia may be less likely to develop diabetic retinopathy (DR). The relationship between refractive error, ocular biometry, and DR therefore was investigated.
Population-based, cross-sectional study.
Persons with diabetes from the Singapore Malay Eye Study (SiMES).
Diabetes mellitus was defined as random glucose of 11.1 mmol/l or more, use of diabetic medication, or a physician diagnosis of diabetes. Spherical equivalent refraction (SE) was assessed using an autokeratorefractometer and subjective refraction. Axial length (AL) and anterior chamber depth (ACD) were measured by IOLMaster (Carl Zeiss Meditec AG, Jena, Germany). Diabetic retinopathy was graded from retinal photographs.
Any DR was defined by characteristic lesions defined by the Early Treatment Diabetic Retinopathy Study (ETDRS); moderate DR by ETDRS retinopathy severity scores of 43 or higher; and vision-threatening retinopathy by severe nonproliferative retinopathy, proliferative DR, or clinically significant macular edema.
Of 3280 adult Malay participants (78.7% response), 629 persons with diabetes contributed to this analysis. In multivariate analyses adjusting for age, gender, education, height, cataract, hypertension, hemoglobin A1c, and other factors, eyes with myopic SE were less likely to have any DR (odds ratio [OR], 0.90; 95% confidence interval [CI], 0.84-0.96; P = 0.002, per 1-diopter [D] decrease), moderate DR (OR, 0.83; 95% CI, 0.73-0.93; P = 0.001, per 1-D decrease), and vision-threatening DR (OR, 0.77; 95% CI, 0.67-0.88; P<0.001, per 1-D decrease). Eyes with longer AL were less likely to have any DR (OR, 0.86; 95% CI, 0.75-0.99; P = 0.041, per 1-mm increase), moderate DR (OR, 0.80; 95% CI, 0.62-1.05; P = 0.11, per 1-mm increase), and vision-threatening DR (OR, 0.63; 95% CI, 0.40-0.99; P = 0.044, per mm increase). Eyes with deeper ACD were less likely to have moderate DR (OR, 0.32; 95% CI, 0.16-0.64; P = 0.001, per 1-mm increase) and vision-threatening DR (OR, 0.14; 95% CI, 0.06-0.36; P = 0.001, per 1-mm increase).
Myopic refraction and longer AL are associated with a lower risk of DR, particularly vision-threatening retinopathy, without any evidence of a threshold.
近视的眼睛可能不太容易发生糖尿病视网膜病变（DR）。因此，研究了屈光不正、眼生物测量和 DR 之间的关系。
基于人群的横断面研究。
来自新加坡马来眼研究（SiMES）的糖尿病患者。
糖尿病的定义为随机血糖≥11.1mmol/L、使用糖尿病药物或医生诊断为糖尿病。使用自动角膜曲率计和主观验光评估等效球镜（SE）。使用 IOLMaster（卡尔蔡司 Meditec AG，耶拿，德国）测量眼轴（AL）和前房深度（ACD）。糖尿病视网膜病变根据视网膜照片进行分级。
任何 DR 均由早期治疗糖尿病视网膜病变研究（ETDRS）定义的特征性病变定义；中度 DR 由 ETDRS 视网膜严重程度评分≥43 定义；严重非增殖性视网膜病变、增殖性 DR 或临床显著黄斑水肿定义为威胁视力的视网膜病变。
在 3280 名成年马来参与者（78.7%的应答率）中，有 629 名糖尿病患者参与了这项分析。在调整年龄、性别、教育程度、身高、白内障、高血压、血红蛋白 A1c 和其他因素的多变量分析中，近视 SE 的眼睛发生任何 DR 的可能性较低（比值比[OR]，0.90；95%置信区间[CI]，0.84-0.96；P=0.002，每 1 屈光度[D]下降），中度 DR（OR，0.83；95% CI，0.73-0.93；P=0.001，每 1-D 下降）和威胁视力的 DR（OR，0.77；95% CI，0.67-0.88；P<0.001，每 1-D 下降）。AL 较长的眼睛发生任何 DR 的可能性较低（OR，0.86；95% CI，0.75-0.99；P=0.041，每增加 1mm），中度 DR（OR，0.80；95% CI，0.62-1.05；P=0.11，每增加 1mm）和威胁视力的 DR（OR，0.63；95% CI，0.40-0.99；P=0.044，每增加 1mm）。ACD 较深的眼睛发生中度 DR 的可能性较低（OR，0.32；95% CI，0.16-0.64；P=0.001，每增加 1mm）和威胁视力的 DR（OR，0.14；95% CI，0.06-0.36；P=0.001，每增加 1mm）。
近视屈光和较长的 AL 与 DR 风险降低相关，尤其是威胁视力的视网膜病变，且没有任何证据表明存在阈值。
