Liew Gerald, Wong Vincent W, Ho I-Van
a Centre for Vision Research, Westmead Millennium Institute of Medical Research , University of Sydney , Sydney , Australia.
b Liverpool Diabetes Collaborative Research Unit , Ingham Institute of Applied Science , Sydney , Australia.
Ophthalmic Epidemiol. 2017 Apr;24(2):73-80. doi: 10.1080/09286586.2016.1259638. Epub 2017 Jan 19.
Diabetic retinopathy is a leading cause of blindness worldwide. The last 3 decades have seen major improvements in glycemic and blood pressure control as well as the introduction of national screening programs, and we sought to determine if rates of proliferative diabetic retinopathy have changed as a result.
We conducted a systematic review to determine whether the incidence and progression rates of proliferative diabetic retinopathy and sight-threatening retinopathy have changed, focusing on large population-based studies with objective assessment of diabetic retinopathy.
Comparisons across different studies is problematic due to different baseline retinopathy severity, different reported outcomes and different follow-up periods, but within these constraints certain trends could be identified. This review provides evidence that the incidence and progression of these conditions has reduced by approximately 2-3 fold over the last 3 decades.
These results have implications for current diabetic retinopathy screening guidelines and has identified future areas where research could be improved.
糖尿病视网膜病变是全球失明的主要原因。在过去30年里，血糖和血压控制取得了重大进展，同时也推行了全国性筛查项目，我们试图确定增殖性糖尿病视网膜病变的发生率是否因此发生了变化。
我们进行了一项系统评价，以确定增殖性糖尿病视网膜病变和威胁视力的视网膜病变的发病率及进展率是否发生了变化，重点关注基于人群的大型研究，这些研究对糖尿病视网膜病变进行了客观评估。
由于不同的基线视网膜病变严重程度、不同的报告结果和不同的随访期，不同研究之间的比较存在问题，但在这些限制条件下可以确定某些趋势。本评价提供的证据表明，在过去30年里，这些疾病的发病率和进展率降低了约2至3倍。
这些结果对当前的糖尿病视网膜病变筛查指南具有启示意义，并确定了未来研究可改进的领域。
