Romero-Aroca Pedro, de la Riva-Fernandez Sofia, Valls-Mateu Aida, Sagarra-Alamo Ramon, Moreno-Ribas Antonio, Soler Nuria
Ophthalmic Service, University Hospital Sant Joan, Institut de Investigacio Sanitaria Pere Virgili (IISPV), University Rovira & Virgili, Reus, Spain.
Department of Computer Engineering and Mathematics, University Rovira & Virgili, Reus, Spain.
Br J Ophthalmol. 2016 Oct;100(10):1366-71. doi: 10.1136/bjophthalmol-2015-307689. Epub 2016 Jan 14.
BACKGROUND/AIMS: To determine the changes in the incidence of diabetic retinopathy (DR), diabetic macular oedema (DMO) and their risk factors in a population-based study of patients with diabetes mellitus (DM) referred to our 16 Primary Health Care Areas (HCAs).
Prospective population-based study of a total of 15 396 Caucasian patients with DM, who represent 86.53% of the total patients with DM in our HCAs, were studied over an 8-year follow-up period. All patients were screened with a mean follow-up of 3.18±1.11 times for each patient over the 8 years.
The yearly mean value of any DR was 8.37±2.19% (8.09%-8.99%); of advanced DR yearly mean value of 0.46±0.22% (0.03-0.78); and of DMO a yearly mean value of 2.19±0.18% (2%-2.49%). A clear increase was observed in the last 3 years, any DR increased from 8.09% in 2007 to 8.99% in 2014, and DMO from 2% in 2007 to 2.49% in 2014. These increases were more evident in some age groups. For patients with any DR aged 41-50 and 51-60 and for patients with advanced DR aged 41-50, 51-60 and 61-70, the increase was more marked, related to an increase in HbA1c values or to patients treated with insulin.
An increase in the incidence of DR and DMO was observed, especially in the younger patients aged between 31 and 70 years. This is linked to bad metabolic control of DM. Our results suggest a greater number of ocular complications in the near future, such as neovascular glaucoma, if these current findings are not addressed.
背景/目的：在一项针对转诊至我们16个初级卫生保健区域（HCA）的糖尿病（DM）患者的基于人群的研究中，确定糖尿病视网膜病变（DR）、糖尿病性黄斑水肿（DMO）的发病率变化及其危险因素。
对总共15396名白种人DM患者进行基于人群的前瞻性研究，这些患者占我们HCA中DM患者总数的86.53%，在8年的随访期内进行研究。所有患者均接受筛查，每位患者在8年中的平均随访次数为3.18±1.11次。
任何DR的年平均值为8.37±2.19%（8.09%-8.99%）；晚期DR的年平均值为0.46±0.22%（0.03-0.78）；DMO的年平均值为2.19±0.18%（2%-2.49%）。在过去3年中观察到明显增加，任何DR从2007年的8.09%增加到2014年的8.99%，DMO从2007年的2%增加到2014年的2.49%。这些增加在某些年龄组中更为明显。对于年龄在41-50岁和51-60岁的任何DR患者以及年龄在41-50岁、51-60岁和61-70岁的晚期DR患者，增加更为显著，这与糖化血红蛋白（HbA1c）值的增加或接受胰岛素治疗的患者有关。
观察到DR和DMO的发病率增加，尤其是在31至70岁的年轻患者中。这与DM的不良代谢控制有关。我们的结果表明，如果不解决当前这些发现，在不久的将来会出现更多眼部并发症，如新血管性青光眼。
