Internal Medicine Unit, Edéa Regional Hospital, PO Box 100, Edéa, Cameroon.
BMC Ophthalmol. 2014 Feb 24;14:19. doi: 10.1186/1471-2415-14-19.
Diabetic retinopathy (DR) is the most common microvascular complication of diabetes. It can lead to significant visual loss. The aim of this study was to determine the frequency and clinical profile of diabetic retinopathy, and assess the outcomes of laser photocoagulation therapy in a diabetic population in Cameroon.
We carried out a prospective cohort study during 24 months in the Department of Ophthalmology of the Douala General Hospital, Cameroon. We included all diabetic patients who were referred from diabetes clinics for ophthalmologic evaluation. Data included type and duration of diabetes, visual acuity, intra-ocular pressure, results of fundoscopy and fluorescein angiography, and outcomes two months after treatment with laser photocoagulation.
We included 407 patients; 88% had type 2 diabetes. Their mean duration of diabetes was 6.4 years (SD=6.6). Forty point three percent (164/407) of patients were found to have DR on fundoscopy. Of the 164 patients with DR, 63.4% (104/164) had non-proliferative and 36.6% (60/164) had proliferative DR. Diabetic maculopathy was found in 14.5% (59/407) of all participants, and 36% (59/164) of patients with DR. There was a strong correlation between the duration of diabetes and retinopathy status (p < 0.001, r = 0.9541). Overall, 17.4% (71/407) of patients were eligible for laser photocoagulation. Of these, 66.2% (47/71) were treated, and 78.7% (37/47) of treated patients came back for control two months later. Among these treated patients an improvement of the retinopathy was noted in 73% (27/37), no change in 16.2% (6/37) and a worsening in 10.8% (4/37). Severe proliferative DR was significantly associated with treatment failure (p < 0.001).
The frequency of DR may be high among diabetic patients in Cameroon. There was a good uptake of laser photocoagulation therapy among patients affected by DR in our setting, with good treatment outcomes. Interventions to prevent diabetes and increase the precocity of diagnosis and treatment of DR should be scaled up.
糖尿病视网膜病变（DR）是糖尿病最常见的微血管并发症，可导致严重的视力丧失。本研究旨在确定喀麦隆糖尿病患者中糖尿病视网膜病变的频率和临床特征，并评估激光光凝治疗的结果。
我们在喀麦隆杜阿拉总医院眼科进行了为期 24 个月的前瞻性队列研究。我们纳入了所有从糖尿病诊所转介来进行眼科评估的糖尿病患者。数据包括糖尿病的类型和持续时间、视力、眼内压、眼底镜和荧光素血管造影检查结果，以及激光光凝治疗后两个月的治疗结果。
我们纳入了 407 例患者，88%为 2 型糖尿病患者。他们的糖尿病平均病程为 6.4 年（标准差=6.6）。40.3%（164/407）的患者在眼底镜检查中发现有 DR。在 164 例 DR 患者中，63.4%（104/164）为非增生性，36.6%（60/164）为增生性 DR。所有参与者中糖尿病性黄斑病变的发生率为 14.5%（59/407），DR 患者中为 36%（59/164）。糖尿病病程与视网膜病变状态之间存在很强的相关性（p<0.001，r=0.9541）。总体而言，407 例患者中有 17.4%（71/407）适合激光光凝治疗。其中，66.2%（47/71）接受了治疗，78.7%（37/47）的治疗患者在两个月后回来进行了控制。在这些接受治疗的患者中，73%（27/37）的视网膜病变得到改善，16.2%（6/37）无变化，10.8%（4/37）恶化。严重增生性 DR 与治疗失败显著相关（p<0.001）。
在喀麦隆的糖尿病患者中，DR 的发生率可能很高。在我们的环境中，受 DR 影响的患者对激光光凝治疗的接受程度较高，治疗效果良好。应该扩大预防糖尿病和提高 DR 早期诊断和治疗的干预措施。
