撒哈拉以南非洲地区的糖尿病与视力损害：来自喀麦隆的证据。
Diabetes and visual impairment in sub-Saharan Africa: evidence from Cameroon.
作者信息
Jingi Ahmadou M, Nansseu Jobert Richie N, Noubiap Jean Jacques N, Bilong Yannick, Ellong Augustin, Mvogo Côme Ebana
机构信息
Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon.
Department of Public Health, Faculty of Medicine and Biomedical Sciences, Yaoundé, Cameroon.
出版信息
J Diabetes Metab Disord. 2015 Apr 8;14:21. doi: 10.1186/s40200-015-0151-4. eCollection 2015.
BACKGROUND
"Vision 2020 - the right to sight" is a program which purpose is to eliminate avoidable blindness by the year 2020 through the implementation of concrete action plans at the national and district levels. Accordingly, baseline data are needed for the planning, monitoring, follow-up and evaluation of this program. The present study aimed to better characterize visual impairment and blindness in Cameroonian diabetics by providing with baseline data on the prevalence and main causes of these affections.
METHODS
This was a hospital-based cross-sectional study, conducted from October 2004 to October 2006 at the Department of Ophthalmology of the Douala General Hospital, Cameroon. We included 407 diabetic patients who were referred from diabetes clinics for ophthalmologic evaluation. Ophthalmologic data included visual acuity, intra-ocular pressure, fundoscopy and fluorescein angiography.
RESULTS
The prevalence of blindness and poor vision were respectively 12.3% and 17.4% with regard to the worst eyes. Fifty nine (14.5%) patients were found with diabetic maculopathy, of whom 25.4% (15/59) had poor vision, and 25.4% (15/59) were blind. The prevalence of sight threatening retinopathy (severe non-proliferative and proliferative) was 17.4%. The degree of visual impairment was comparable in both diabetic types (p = 0.825), and it increased with the severity of retinopathy (p < 0.0001), as well as that of maculopathy (p <0.0001). The prevalence of glaucoma was 15% (61/407) when considering the worst eyes. The severity of visual impairment increased with the severity of glaucoma (p = 0.001). One hundred and twenty-one (29.7%) patients presented with cataract irrespective of its location or severity. Cataract was significantly associated with poor vision and blindness (p < 0.0001). Hypertensive retinopathy (4.9%), papillary ischaemia (2.7%), vaso-occlusive eye disease (2.5%), and age-related macular edema (2%) were the other potential causes of visual impairment and blindness encountered the most in our setting. Age ≥ 50 years, male sex, duration of diabetes and hypertension variously increased the risk of having glaucoma, cataract, diabetic retinopathy or maculopathy.
CONCLUSION
Poor vision and blindness are frequent in Cameroonian diabetics, and their causes are similar to those reported by various other surveys: mainly cataract, glaucoma, diabetic retinopathy and maculopathy.
背景
“视觉2020——享有看见的权利”是一项旨在通过在国家和地区层面实施具体行动计划，到2020年消除可避免盲症的项目。因此，该项目的规划、监测、随访和评估需要基线数据。本研究旨在通过提供这些病症患病率和主要病因的基线数据，更好地描述喀麦隆糖尿病患者的视力损害和失明情况。
方法
这是一项基于医院的横断面研究，于2004年10月至2006年10月在喀麦隆杜阿拉总医院眼科进行。我们纳入了407名从糖尿病诊所转诊来进行眼科评估的糖尿病患者。眼科数据包括视力、眼压、眼底镜检查和荧光素血管造影。
结果
就最差眼而言，失明和视力低下的患病率分别为12.3%和17.4%。发现59例（14.5%）患者患有糖尿病性黄斑病变，其中25.4%（15/59）视力低下，25.4%（15/59）失明。威胁视力的视网膜病变（重度非增殖性和增殖性）患病率为17.4%。两种糖尿病类型的视力损害程度相当（p = 0.825），且随着视网膜病变严重程度（p < 0.0001）以及黄斑病变严重程度（p < 0.0001）的增加而加重。考虑最差眼时，青光眼患病率为15%（61/407）。视力损害的严重程度随着青光眼严重程度的增加而加重（p = 0.001）。121例（29.7%）患者存在白内障，无论其位置或严重程度如何。白内障与视力低下和失明显著相关（p < 0.0001）。高血压性视网膜病变（4.9%）、乳头缺血（2.7%）、血管阻塞性眼病（2.5%）和年龄相关性黄斑水肿（2%）是我们研究中最常遇到的其他视力损害和失明的潜在病因。年龄≥50岁、男性、糖尿病病程和高血压分别不同程度地增加了患青光眼、白内障、糖尿病视网膜病变或黄斑病变的风险。
结论
喀麦隆糖尿病患者中视力低下和失明很常见，其病因与其他各种调查报道的相似：主要是白内障、青光眼、糖尿病视网膜病变和黄斑病变。
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