Lawan Abdu, Mohammed Tijjani Bashir
Department of Ophthalmology, Bayero University, Kano, Nigeria.
Ann Afr Med. 2012 Apr-Jun;11(2):75-9. doi: 10.4103/1596-3519.93528.
The aim of the study is to determine the pattern of retinopathy seen in diabetic patients attending the outpatient clinic in Aminu Kano Teaching Hospital, Kano, Nigeria.
Consecutive patients who were attending the diabetic clinic and who consented were examined over a three-month period. Information obtained includes patient's bio data, type and duration of disease, and findings on eye examination. The fundus was examined with direct and indirect ophthalmoscopes, +90 D with slit lamp and fundal photography. Retinopathy was graded using the International Clinical Diabetic Retinopathy Disease Severity Scale (ICDRDSS).
A total of 214 patients were examined during the study period. There were 88 males and 126 females (M: F = 1: 1.43). The mean age of the study population was 52.14 ± 13.23 years. The mean age of patients without diabetic retinopathy (DR) was 49.14 ± 13.17 years and the mean age of patients with DR was 58.51 ± 10.94 years. Forty nine patients (23%) had insulin-dependent diabetes mellitus (IDDM) while 165 patients (77%) had non insulin dependent diabetes mellitus (NIDDM). There was statistically significant difference in presence of retinopathy in patients with IDDM compared to those with NIDDM [X(2) =29.77 {95% CI}, P=0.000]. DR was significantly more common in patients with disease duration of 15 years or more compared with those with disease duration of 14 years or less [X(2) = 65.85, {95% CI} P= 0.000]. Based on ICDRDSS scale, 136 patients (64%) had no retinopathy and 78 patients (36%) had retinopathy. Some patients were visually impaired and the cause of blindness was DR in 6 patients (2.8%). Cataract and glaucoma were the cause in 6 patients (2.8%).
Diabetic retinopathy is common in our environment and is more frequent in IDDM and those with long disease duration. DR is a cause of visual disability although diabetic patients are not exempted from blindness from other eye diseases such as cataract and glaucoma. A screening program needs to be developed to facilitate early detection and prompt treatment.
本研究的目的是确定在尼日利亚卡诺阿明努·卡诺教学医院门诊就诊的糖尿病患者中视网膜病变的模式。
在三个月的时间里，对连续就诊于糖尿病门诊且同意参与研究的患者进行检查。获取的信息包括患者的生物数据、疾病类型和病程，以及眼部检查结果。使用直接和间接检眼镜、带裂隙灯的+90D透镜以及眼底摄影对眼底进行检查。视网膜病变采用国际临床糖尿病视网膜病变疾病严重程度量表（ICDRDSS）进行分级。
在研究期间共检查了214例患者。其中男性88例，女性126例（男：女 = 1：1.43）。研究人群的平均年龄为52.14±13.23岁。无糖尿病视网膜病变（DR）患者的平均年龄为49.14±13.17岁，患有DR的患者平均年龄为58.51±10.94岁。49例患者（23%）患有胰岛素依赖型糖尿病（IDDM），165例患者（77%）患有非胰岛素依赖型糖尿病（NIDDM）。与NIDDM患者相比，IDDM患者中视网膜病变的发生率存在统计学显著差异[X(2)=29.77{95%置信区间}，P = 0.000]。病程15年及以上的患者DR明显比病程14年及以下的患者更常见[X(2)=65.85，{95%置信区间}P = 0.000]。根据ICDRDSS量表，136例患者（64%）没有视网膜病变，78例患者（36%）患有视网膜病变。一些患者有视力障碍，6例患者（2.8%）失明的原因是DR。6例患者（2.8%）失明的原因是白内障和青光眼。
在我们的环境中，糖尿病视网膜病变很常见，在IDDM患者和病程较长的患者中更频繁。DR是视力残疾的一个原因，尽管糖尿病患者也不能免于因白内障和青光眼等其他眼部疾病导致的失明。需要制定一个筛查计划，以促进早期发现和及时治疗。
