Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
Department of Biostatistics, Catholic University College of Medicine, Seoul, Korea.
J Diabetes Investig. 2018 Jan;9(1):173-178. doi: 10.1111/jdi.12655. Epub 2017 Jun 15.
AIMS/INTRODUCTION: The present study aimed to analyze the temporal changes in the prevalence, screening rate, visual impairments and treatment patterns of diabetic retinopathy in the Korean population over 8 years.
This was a retrospective population-based study of Korean national health insurance beneficiaries aged 30 years or older with type 2 diabetes, obtained from the Korean National Health Insurance Claims database from 2006 to 2013 (n = 1,655,495 in 2006 and 2,720,777 in 2013). The annual prevalence rates of diabetes, diabetic retinopathy, dilated fundus examinations, visual impairment, laser treatment and vitrectomy, as determined based on diagnostic and treatment codes, were analyzed.
There was a steady increase in the prevalence of diabetic retinopathy, from 14.3% in 2006 to 15.9% in 2013. However, the incidence of new diabetic retinopathy cases decreased from 6.7/100 person-years in 2006 to 5.6 in 2013. Approximately 98% of patients underwent at least one dilated fundus examination during the follow-up period. The prevalence of diabetic retinopathy peaked in the 60-69 years age group. The prevalence of diabetic retinopathy was higher in female than in male diabetes patients. The proportion of patients who underwent an annual dilated fundus examination improved from 24.3% in 2006 to 30.0% in 2013. Among patients with diabetic retinopathy, constant decreases in the proportions of those who received laser treatment (11.4% in 2006 to 6.9% in 2013) and who underwent vitrectomy (2.4% in 2006 to 1.7% in 2013) were noted. Additionally, a decreasing trend in the prevalence of visual impairment was noted among the patients with diabetic retinopathy, from 2% (4,820/237,267) in 2006 to 0.08% (3,572/431,964) in 2013.
Although there was a rapid increase in the prevalence of diabetes in the Korean population in the past decade, the prevalence of diabetic retinopathy remained stable during the study period. However, just three out of 10 patients with diabetes underwent regular annual dilated fundus examinations. Thus, an improvement in the continuity of diabetic retinopathy screening among patients with diabetes is necessary to reduce the risk of visual impairment as a result of diabetic retinopathy.
目的/引言：本研究旨在分析韩国人群中 8 年来糖尿病视网膜病变的患病率、筛查率、视力障碍和治疗模式的时间变化。
这是一项回顾性的基于人群的研究，纳入了韩国国民健康保险受益人的 30 岁或以上的 2 型糖尿病患者，数据来源于 2006 年至 2013 年的韩国国家健康保险索赔数据库（2006 年为 1655495 例，2013 年为 2720777 例）。根据诊断和治疗代码，分析了糖尿病、糖尿病视网膜病变、眼底扩张检查、视力障碍、激光治疗和玻璃体切除术的年度患病率。
糖尿病视网膜病变的患病率呈稳步上升趋势，从 2006 年的 14.3%上升到 2013 年的 15.9%。然而，新诊断的糖尿病视网膜病变病例的发病率从 2006 年的每 100 人年 6.7 例下降到 2013 年的 5.6 例。在随访期间，约 98%的患者至少进行了一次眼底扩张检查。糖尿病视网膜病变的患病率在 60-69 岁年龄组达到峰值。女性糖尿病患者的糖尿病视网膜病变患病率高于男性。每年进行眼底扩张检查的患者比例从 2006 年的 24.3%提高到 2013 年的 30.0%。在患有糖尿病视网膜病变的患者中，激光治疗（2006 年为 11.4%，2013 年为 6.9%）和玻璃体切除术（2006 年为 2.4%，2013 年为 1.7%）的比例持续下降。此外，患有糖尿病视网膜病变的患者视力障碍的患病率也呈下降趋势，从 2006 年的 2.0%（4820/237267）下降到 2013 年的 0.08%（3572/431964）。
尽管在过去十年中，韩国人群中糖尿病的患病率迅速上升，但在研究期间，糖尿病视网膜病变的患病率保持稳定。然而，只有十分之三的糖尿病患者接受了定期的年度眼底扩张检查。因此，需要提高糖尿病患者糖尿病视网膜病变筛查的连续性，以降低因糖尿病视网膜病变导致视力障碍的风险。
