Centre for Eye Research Australia, the Royal Victorian Eye and Ear Hospital, University of Melbourne, Melbourne, Victoria, Australia.
Ophthalmology. 2010 Apr;117(4):757-65. doi: 10.1016/j.ophtha.2009.09.035. Epub 2010 Feb 1.
To assess the influence of the spectrum of diabetic retinopathy (DR) on vision-specific function in an Asian population.
Population-based cross-sectional study.
Persons aged 40 to 80 years of Malay ethnicity in Singapore.
The Singapore Malay Eye Study was a population-based, cross-sectional study of 3280 Asian Malays (78.7% response rate). Five end points were considered: (1) any DR, (2) macular edema (ME), (3) clinically significant macular edema (CSME), (4) vision-threatening DR (VTDR), and (5) DR severity levels ranging from none to proliferative diabetic retinopathy (PDR). Vision function was assessed using the Vision-Specific Functioning Scale validated using Rasch analysis.
Vision-specific functioning score.
Of 357 diabetic participants in the study, 23.2% had any DR, 5.6% had ME, 5.0% had CSME, 10.6% had VTDR, and 6.2% had PDR. In linear regression models adjusting for age, gender, stroke, diabetic risk factors, and socioeconomic factors, poorer vision-specific function was associated independently with any DR (beta, -0.21; P<0.05), ME (beta, -0.48; P<0.05), CSME (beta, -0.42; P<0.05), VTDR (beta, -0.64; P<0.05), and PDR (beta, -0.92; P<0.001). When controlling further for presenting visual acuity, VTDR (beta, -0.37; P = 0.01) and PDR (beta, -0.61; P = 0.002) were the only 2 DR categories independently associated with poorer vision-specific function and PDR. Persons with VTDR and PDR were 6 to 12 times more likely to report lower participation in daily living activities than those without these DR levels.
People with VTDR and PDR have substantial difficulty undertaking vision-specific daily activities. These findings reinforce the importance of preventative efforts targeted at the earliest DR stages to prevent progression to later stages of DR.
FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found after the references.
评估糖尿病视网膜病变（DR）谱在亚洲人群视力特定功能中的影响。
基于人群的横断面研究。
新加坡马来族 40 至 80 岁人群。
新加坡马来眼研究是一项基于人群的 3280 名亚洲马来人（78.7%的应答率）的横断面研究。考虑了五个终点：（1）任何 DR，（2）黄斑水肿（ME），（3）临床显著黄斑水肿（CSME），（4）威胁视力的 DR（VTDR），以及（5）从无到增生性糖尿病视网膜病变（PDR）的 DR 严重程度级别。使用经 Rasch 分析验证的视力特定功能量表评估视力功能。
视力特定功能评分。
在研究中的 357 名糖尿病患者中，23.2%有任何 DR，5.6%有 ME，5.0%有 CSME，10.6%有 VTDR，6.2%有 PDR。在调整年龄、性别、中风、糖尿病危险因素和社会经济因素的线性回归模型中，较差的视力特定功能与任何 DR（β，-0.21；P<0.05）、ME（β，-0.48；P<0.05）、CSME（β，-0.42；P<0.05）、VTDR（β，-0.64；P<0.05）和 PDR（β，-0.92；P<0.001）独立相关。当进一步控制当前视力时，VTDR（β，-0.37；P=0.01）和 PDR（β，-0.61；P=0.002）是仅与较差的视力特定功能和 PDR 相关的 2 个 DR 类别。患有 VTDR 和 PDR 的人报告参与日常活动的次数比没有这些 DR 水平的人少 6 至 12 倍。
患有 VTDR 和 PDR 的人在进行特定于视力的日常活动方面有很大困难。这些发现强调了针对 DR 早期阶段进行预防工作的重要性，以防止其进展为更晚期的 DR。
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