Ophthalmology Unit, Department of Surgery, Obafemi Awolowo University Teaching Hospital, Ile-Ife, 220005, Nigeria.
Eur J Intern Med. 2010 Jun;21(3):176-9. doi: 10.1016/j.ejim.2010.01.009. Epub 2010 Feb 11.
To assess the prevalence and factors influencing previous dilated eye examination in screening for retinopathy among type II diabetics.
Cross-sectional study of type II diabetic patients receiving treatment at a tertiary hospital in southwestern Nigeria was conducted with information on gender, age, duration of diabetes, current medication and previous dilated eye examination recorded. Eye examination included visual acuity, pen torch examination, applanation tonometry and direct ophthalmoscopy of the dilated eye in a dark room. Visual acuity was presented as classified by WHO while data was analyzed using SPSS version 11 and statistical significance inferred at P<0.05.
Eighty three type II diabetics with mean age 57.5+/-10.8 years and mean duration of diabetes of 6.6 years were studied. Visual impairment (<6/18 in the better eye) and blindness (<3/60 in the better eye) were recorded in 3.6% and 12% of the patients respectively while diabetic retinopathy was present in 21.6%. Only 24 [28.9%] diabetics had previous dilated eye examination; absence of eye symptoms [50.8%] and lack of referral [45.8%] were the main barriers to having previous dilated eye examination. Previous dilated eye examination was significantly influenced by the presence of visual impairment/blindness [P=0.002], longer duration diabetes mellitus [P=0.006], current insulin treatment [P=0.040] and presence of non-diabetic vision threatening eye diseases [P=0.016].
Dilated eye examination rate is low; inadequate knowledge about diabetic retinopathy as well as low referral rates is contributory. Massive health education on diabetic retinopathy as well as development of sustainable retinopathy screening protocol would be helpful.
评估在筛查 II 型糖尿病患者视网膜病变时，先前散瞳检查的流行情况及其影响因素。
对在尼日利亚西南部一家三级医院接受治疗的 II 型糖尿病患者进行横断面研究，记录性别、年龄、糖尿病病程、当前用药情况和先前散瞳检查情况。眼部检查包括视力、检眼镜检查、眼压计眼压测量和暗室直接眼底镜检查。视力以世界卫生组织（WHO）的分类标准呈现，数据采用 SPSS 版本 11 进行分析，并推断 P<0.05 时的统计学意义。
研究纳入了 83 名平均年龄为 57.5+/-10.8 岁、平均病程为 6.6 年的 II 型糖尿病患者。3.6%的患者视力受损（较好眼视力<6/18），12%的患者失明（较好眼视力<3/60），21.6%的患者患有糖尿病视网膜病变。仅有 24 名[28.9%]糖尿病患者进行过先前的散瞳检查；50.8%的患者没有眼部症状，45.8%的患者没有转诊，这是他们没有进行先前散瞳检查的主要原因。先前的散瞳检查显著受到视力受损/失明（P=0.002）、较长的糖尿病病程（P=0.006）、当前胰岛素治疗（P=0.040）和非糖尿病性威胁视力的眼部疾病存在（P=0.016）的影响。
散瞳检查率较低；对糖尿病视网膜病变的认识不足以及转诊率低是导致这种情况的原因。大规模的糖尿病视网膜病变健康教育以及制定可持续的视网膜病变筛查方案将有所帮助。
