Rani Padmaja Kumari, Raman Rajiv, Gella Laxmi, Kulothungan Vaitheeswaran, Sharma Tarun
Shri Bhagwan Mahavir Vitreoretinal Services, 18 College Road, Sankara Nethralaya, Chennai, Tamil Nadu, India.
Middle East Afr J Ophthalmol. 2012 Jan;19(1):129-34. doi: 10.4103/0974-9233.92129.
To report the prevalence of visual impairment (VI) and the associated risk factors in type II diabetic subjects.
The study included type II diabetes mellitus subjects who were enrolled from a cross-sectional study. Participants underwent biochemical testing and comprehensive ocular examination including stereo fundus photography. The VI was defined based on the World Health Organization criteria.
The prevalence of VI was 4% in the cohort. The risk factors associated with the presence of VI included a female gender, age greater than 60 years, low socio-economic status, hypertension, microalbuminuria, macroalbuminuria, neuropathy, use of insulin and alcohol. Various ocular risk factors are nuclear sclerosis, subjects who have undergone cataract surgery, myopia and sight-threatening diabetic retinopathy (STDR). After adjusting for the factors using stepwise logistic regression analysis, hypertension, use of alcohol, post-cataract surgery and myopia were not risk factors. Stepwise logistic regression analysis indicated that VI was higher among subjects older than 60 years (odds ratio (OR): 4.95 [2.67-9.15]) and those who belonged to a low socio-economic status (OR: 2.91 [1.24-6.85]). The systemic risk factors for VI included microalbuminuria (OR: 2.91 [1.59-5.33]), macroalbuminuria (OR: 4.65 [1.57-13.77]) and presence of neuropathy (OR: 1.97 [1.09-3.59]) among subjects. Subjects with nuclear sclerosis (OR: 36.82 [11.12-112.36]) and presence of STDR (OR: 4.17 [1.54-11.29]) were at a higher risk of VI. Cataract was the most common cause of VI in the cohort.
Visual impairment, among type II diabetic subjects (4%), is a major public health problem that needs to be addressed. Cataract is the most common reversible cause of vision impairment in this population.
报告2型糖尿病患者视力损害（VI）的患病率及其相关危险因素。
本研究纳入了一项横断面研究中的2型糖尿病患者。参与者接受了生化检测和包括立体眼底摄影在内的全面眼部检查。视力损害根据世界卫生组织标准定义。
该队列中视力损害的患病率为4%。与视力损害相关的危险因素包括女性、年龄大于60岁、社会经济地位低、高血压、微量白蛋白尿、大量白蛋白尿、神经病变、使用胰岛素和饮酒。各种眼部危险因素包括核硬化、接受过白内障手术的患者、近视和威胁视力的糖尿病视网膜病变（STDR）。在使用逐步逻辑回归分析对这些因素进行校正后，高血压、饮酒、白内障手术后和近视不是危险因素。逐步逻辑回归分析表明，60岁以上的患者（优势比（OR）：4.95 [2.67 - 9.15]）和社会经济地位低的患者（OR：2.91 [1.24 - 6.85]）视力损害的发生率更高。视力损害的全身危险因素包括微量白蛋白尿（OR：2.91 [1.59 - 5.33]）、大量白蛋白尿（OR：4.65 [1.57 - 13.77]）以及患者存在神经病变（OR：1.97 [1.09 - 3.59]）。患有核硬化的患者（OR：36.82 [11.12 - 112.36]）和存在STDR的患者（OR：4.17 [1.54 - 11.29]）发生视力损害的风险更高。白内障是该队列中视力损害最常见的原因。
2型糖尿病患者中存在视力损害（4%），这是一个需要解决的主要公共卫生问题。白内障是该人群中视力损害最常见的可逆转原因。
