Fung Mavis M Y, Yap Maurice K H, Cheng Karen K Y
School of Optometry, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, SAR, China.
Clin Exp Optom. 2011 Jan;94(1):63-6. doi: 10.1111/j.1444-0938.2010.00552.x.
Diabetic retinopathy is one of the most common causes of blindness. Timely retinal evaluation is known to prevent or minimise visual loss. This study compared the prevalence of ocular disorders in patients who have and have not undergone a retinal examination since diagnosis of their type 2 diabetes mellitus (T2DM). Such data might be useful for planning purposes by health care authorities and agencies in Hong Kong.
Patients with T2DM aged 30 years or over presented for standardised interviews and screening for diabetic retinopathy. The presence of ocular disorders was recorded and the severity of the retinopathy, if any, was graded using the Early Treatment Diabetic Retinopathy Study (ETDRS) classification.
For the 1058 subjects who participated in this study, the mean age at examination was 61.8 ± 10.5 (SD) years (range, 31-93 years). For the 891 subjects with known diabetes for one year or longer, 62.7 per cent had never undergone an evaluation for diabetic retinopathy since diagnosis of their T2DM. Of the 891 subjects, gradable fundus photographs were available for 853 subjects and nearly 2.0 per cent of these had sight-threatening retinopathy based on the ETDRS classification. Those who had not had an eye examination since diagnosis of their T2DM were more likely to have sight-threatening retinopathy than those who had a retinal evaluation (2.6 versus 0.6 per cent; p = 0.04).
In our sample, over 60 per cent of patients with T2DM for one year or longer had not had a retinal assessment since diagnosis. The risk of developing sight-threatening diabetic retinopathy appears to be higher for those who have not had a retinal assessment.
糖尿病视网膜病变是导致失明的最常见原因之一。已知及时进行视网膜评估可预防或减少视力丧失。本研究比较了自2型糖尿病(T2DM)确诊以来接受和未接受视网膜检查的患者眼部疾病的患病率。这些数据可能有助于香港的医疗保健当局和机构进行规划。
年龄在30岁及以上的T2DM患者接受标准化访谈和糖尿病视网膜病变筛查。记录眼部疾病的存在情况,并使用早期糖尿病视网膜病变治疗研究(ETDRS)分类法对视网膜病变(如有)的严重程度进行分级。
参与本研究的1058名受试者,检查时的平均年龄为61.8±10.5(标准差)岁(范围为31 - 93岁)。在891名已知糖尿病一年或更长时间的受试者中,62.7%自T2DM确诊以来从未接受过糖尿病视网膜病变评估。在这891名受试者中,853名有可分级的眼底照片,根据ETDRS分类,其中近2.0%患有威胁视力的视网膜病变。自T2DM确诊以来未进行过眼部检查的受试者比接受过视网膜评估的受试者更有可能患有威胁视力的视网膜病变(2.6%对0.6%;p = 0.04)。
在我们的样本中,超过60%的T2DM病程一年或更长时间的患者自确诊以来未进行过视网膜评估。未进行视网膜评估的患者发生威胁视力的糖尿病视网膜病变的风险似乎更高。