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卡塔尔40岁及以上糖尿病患者糖尿病视网膜病变的患病率及影响因素:一项基于社区的调查。

Prevalence and determinants of diabetic retinopathy among persons ≥ 40 years of age with diabetes in Qatar: a community-based survey.

作者信息

Elshafei Maha, Gamra Hamad, Khandekar Rajiv, Al Hashimi Mustafa, Pai Anant, Ahmed Mohd Farouk

机构信息

Department of Ophthalmology, Hamad Medical Corporation, Doha, Qatar.

出版信息

Eur J Ophthalmol. 2011 Jan-Feb;21(1):39-47. doi: 10.5301/ejo.2010.2699.

Abstract

PURPOSE

We present the prevalence and determinants of diabetic retinopathy (DR) in persons 40 years and older with diabetes in Qatar.

METHODS

This community-based survey was held in 2009 at 49 randomly selected clusters. Demographic details and history of diabetes mellitus (DM) and its management were collected by nurses. Ophthalmologists examined the retina by slit-lamp biomicroscopy using +90 D lens and/or indirect ophthalmoscopy. Digital photographs of retina were obtained. The best-corrected visual acuity of each eye was noted. Diabetic retinopathy was graded as mild, moderate, or severe nonproliferative DR, proliferative DR, or diabetic macular edema.

RESULTS

We examined 540 (97.3%) participants with DM. Diabetes mellitus status of 487 persons could be confirmed from medical records. The age- and sex-adjusted prevalence of DR among the diabetic population 40 years and older was 23.5% (95% confidence interval [CI] 19.7-27.3), with 8192 cases of DR among patients with DM. Longer duration of diabetes (odds ratio 1.14 [95% CI 1.10-1.19]) and poor glycemic control (odds ratio 1.12 [95% CI 1.02-1.23]) were risk factors for DR. Awareness of regular eye checkup was found in 62% of participants. Only 20% of persons with sight-threatening DR had undergone laser treatment in at least 1 eye. Visual acuity in the better eye was 6/6 to 6/18 in 90% of persons with DR.

CONCLUSIONS

Universal and periodic eye screening of patients with diabetes is recommended in Qatar. Health promotion for primary prevention and resource review are needed for early detection and management of sight-threatening DR.

摘要

目的

我们呈现了卡塔尔40岁及以上糖尿病患者中糖尿病视网膜病变(DR)的患病率及其决定因素。

方法

这项基于社区的调查于2009年在49个随机选取的群组中进行。护士收集了人口统计学细节、糖尿病(DM)病史及其管理情况。眼科医生使用+90D透镜通过裂隙灯生物显微镜检查和/或间接检眼镜检查视网膜。获取了视网膜的数码照片。记录了每只眼睛的最佳矫正视力。糖尿病视网膜病变被分为轻度、中度或重度非增殖性DR、增殖性DR或糖尿病性黄斑水肿。

结果

我们检查了540名(97.3%)糖尿病患者。487人的糖尿病状态可从病历中得到确认。40岁及以上糖尿病患者中经年龄和性别调整后的DR患病率为23.5%(95%置信区间[CI] 19.7 - 27.3),糖尿病患者中有8192例DR病例。糖尿病病程较长(比值比1.14 [95% CI 1.10 - 1.19])和血糖控制不佳(比值比1.12 [95% CI 1.02 - 1.23])是DR的危险因素。62%的参与者知晓定期眼部检查。仅有20%有视力威胁性DR的患者至少一只眼睛接受过激光治疗。90%的DR患者较好眼睛的视力为6/6至6/18。

结论

建议在卡塔尔对糖尿病患者进行普遍且定期的眼部筛查。需要开展初级预防的健康促进以及资源评估,以便早期发现和管理有视力威胁的DR。

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