Trento Marina, Durando Olga, Lavecchia Sonia, Charrier Lorena, Cavallo Franco, Costa Miguel Angelo, Hernández Cristina, Simó Rafael, Porta Massimo
Laboratory of Clinical Pedagogy, Department of Medical Sciences, University of Turin, Turin, Italy.
Department of Public Health and Paediatrics, University of Turin, Turin, Italy.
Endocrine. 2017 Jul;57(1):83-88. doi: 10.1007/s12020-016-1097-0. Epub 2016 Sep 14.
To evaluate vision related quality of life in the patients enrolled in The European Consortium for the Early Treatment of Diabetic Retinopathy, a clinical trial on prevention of diabetic retinopathy. Four-hundred-forty-nine patients, 153 women, with type 2 Diabetes and no or mild diabetic retinopathy were enrolled in a 2-year multicenter randomized controlled trial. The 25-item National Eye Institute Visual Functioning Questionnaire was used to explore 12 subscales of vision related quality of life. The patients were 62.8 ± 6.7 years old and had 11.1 ± 5.6 years known disease duration. Diabetic retinopathy was absent in 193 (43.0 %) and mild in 256 (57.0 %). Patients without diabetic retinopathy were older, had shorter diabetes duration and used less insulin and glucose-lowering agents but did not differ by gender, best corrected visual acuity or any subscale, except vision specific mental health and vision specific role difficulties. Patients with reduced retinal thickness at the ganglion cell layer (n = 36) did not differ for diabetic retinopathy but were older, had lower best corrected visual acuity and worse scores for ocular pain, color vision and peripheral vision. On multivariable analysis, worse scores for general vision remained associated with reduced retinal thickness, diabetes duration and best corrected visual acuity, and scores for visual specific mental health with diabetic retinopathy and lower best corrected visual acuity. Visual specific role difficulties were only associated with reduced best corrected visual acuity. Scores for driving decreased among females, with worsening of Hemoglobin A1c and best corrected visual acuity. Color vision depended only on reduced retinal thickness, and peripheral vision on both reduced thickness and best corrected visual acuity. The National Eye Institute Visual Functioning Questionnaire could detect subtle changes in patients' perception of visual function, despite absent/minimal diabetic retinopathy.
为评估参与欧洲糖尿病视网膜病变早期治疗联盟(一项预防糖尿病视网膜病变的临床试验)的患者的视力相关生活质量,研究人员开展了此项研究。449例2型糖尿病且无糖尿病视网膜病变或仅有轻度糖尿病视网膜病变的患者(其中153例为女性)参与了一项为期2年的多中心随机对照试验。采用25项美国国立眼科研究所视觉功能问卷来探究视力相关生活质量的12个分量表。患者年龄为62.8±6.7岁,已知糖尿病病程为11.1±5.6年。193例(43.0%)患者无糖尿病视网膜病变,256例(57.0%)患者有轻度糖尿病视网膜病变。无糖尿病视网膜病变的患者年龄更大,糖尿病病程更短,胰岛素和降糖药物使用较少,但在性别、最佳矫正视力或任何分量表方面无差异,除了视力特异性心理健康和视力特异性角色困难。神经节细胞层视网膜厚度降低的患者(n = 36)在糖尿病视网膜病变方面无差异,但年龄更大,最佳矫正视力更低,眼部疼痛、色觉和周边视力得分更差。多变量分析显示,总体视力得分较差仍与视网膜厚度降低、糖尿病病程和最佳矫正视力相关,视力特异性心理健康得分与糖尿病视网膜病变和较低的最佳矫正视力相关。视力特异性角色困难仅与最佳矫正视力降低相关。女性驾驶得分随着糖化血红蛋白和最佳矫正视力的恶化而降低。色觉仅取决于视网膜厚度降低,周边视力则取决于视网膜厚度降低和最佳矫正视力。尽管糖尿病视网膜病变不存在/极少,但美国国立眼科研究所视觉功能问卷仍能检测到患者视觉功能感知的细微变化。