The Fred Hollows Foundation New Zealand, University of Otago, Dunedin, New Zealand.
Clin Exp Ophthalmol. 2011 Sep-Oct;39(7):682-90. doi: 10.1111/j.1442-9071.2011.02533.x. Epub 2011 Apr 19.
To determine the prevalence and severity of diabetic eye disease among adults aged ≥40 years with unrecognized diabetes in Fiji.
Population-based cross-sectional survey using multistage cluster random sampling.
1381 (=73.0% participation).
Interview-based questionnaire; visual acuity measured; dilated ocular examination performed; glycosylated haemoglobin (HbA1c) concentration determined.
Prevalence and grade of diabetic retinopathy/maculopathy.
Sample prevalence of diabetes was 44.8% (95%CI 42.2-47.5%), with 63.4% (95%CI 59.5-67.1%) previously undiagnosed (384/606). Predictors of undiagnosed compared with previously diagnosed diabetes were female gender (P = 0.001), rural residence (P = 0.049) and not having a relative with known diabetes (P < 0.001). Twenty-two retinae of participants with previously undiagnosed diabetes were unexaminable (predominantly cataract). Of the remaining 746 eyes, 3.5% (95%CI 2.4-5.1%) had diabetic retinopathy/maculopathy, 1 (0.1%) had proliferative retinopathy and 4 (0.5%) had active significant maculopathy. Of eyes with diabetic disease, two (7.7%, 95%CI 1.0-25.3%) had diabetes-related vision impairment (3/60; 6/60). Sixteen previously undiagnosed participants (4.2%, 95%CI 2.5-6.7%) had diabetic disease evident in at least one eye: for four (all Melanesian women aged >50 years), this was vision-threatening (1.0%; 95%CI 0.3-2.8). Mean HbA1c (10.7 ± 2.6%) of participants undiagnosed and with diabetes eye disease was higher (P < 0.001) than that of those undiagnosed and without.
The prevalence of diabetic eye disease was low among this cohort, but where present, severe vision-threatening retinopathy/maculopathy was relatively common. If diabetic eye disease is to be avoided or ameliorated in Fiji, then community awareness of and access to diabetes diagnostic services must improve, particularly for women and rural dwellers.
在斐济，对未确诊的 40 岁以上成年人进行糖尿病眼病的流行程度和严重程度调查。
使用多阶段聚类随机抽样的基于人群的横断面调查。
1381 名（参与率为 73.0%）。
问卷调查；视力测量；散瞳眼部检查；糖化血红蛋白（HbA1c）浓度测定。
糖尿病视网膜病变/黄斑病变的患病率和分级。
糖尿病的样本患病率为 44.8%（95%CI 42.2-47.5%），其中 63.4%（95%CI 59.5-67.1%）为先前未确诊的病例（384/606）。与已确诊糖尿病相比，未确诊糖尿病的预测因素为女性（P = 0.001）、农村居住（P = 0.049）和没有已知糖尿病亲属（P < 0.001）。606 例先前未确诊糖尿病的参与者中有 22 只眼无法检查（主要为白内障）。在其余 746 只眼中，3.5%（95%CI 2.4-5.1%）患有糖尿病视网膜病变/黄斑病变，1 只（0.1%）患有增殖性视网膜病变，4 只（0.5%）患有活动性显著黄斑病变。在患有糖尿病疾病的眼中，有 2 只（7.7%，95%CI 1.0-25.3%）患有糖尿病相关的视力损害（3/60；6/60）。16 名先前未确诊的参与者（4.2%，95%CI 2.5-6.7%）至少有一只眼患有糖尿病：其中 4 名（均为年龄>50 岁的美拉尼西亚女性），这是威胁视力的疾病（1.0%；95%CI 0.3-2.8%）。未确诊且患有糖尿病眼病的参与者的平均 HbA1c（10.7 ± 2.6%）较高（P < 0.001）。
在该队列中，糖尿病眼病的患病率较低，但如果存在，严重威胁视力的视网膜病变/黄斑病变则相对常见。如果要在斐济避免或改善糖尿病眼病，那么必须提高社区对糖尿病诊断服务的认识和获取途径，特别是对妇女和农村居民。
