Jeganathan V Swetha E, Langford Tim, Sefo Lucilla Ah-Ching, Hewitt Alex W, Verma Nitin
Kellogg Eye Center, University of Michigan, Ann Arbor, MI, USA.
Monash University, Melbourne, VIC, Australia.
Ophthalmol Ther. 2017 Jun;6(1):187-194. doi: 10.1007/s40123-017-0092-8. Epub 2017 May 17.
The purpose of this study was to determine the prevalence of diabetic retinopathy in Samoa by piloting a retinal photography screening programme.
We performed a cross-sectional study of patients with diabetes who presented to the Tupua Tamasese Meaole eye clinic in Apia, Samoa, between May 2011 and September 2011. Study approval was granted by the National Health Service Board of Samoa, the Monash University Human Research Ethics Committee, and the study adhered to the Tenets of the Declaration of Helsinki. Following informed consent, data collection included patient demographics [age, area of residence (rural or urban)], type of diabetes, length of time since diagnosis, most recent random blood sugar and blood pressure levels. The subjects had three 45-degree retinal photographs taken in each eye with the Canon CR6-45NM camera. All gradable photographs were assessed for the presence of diabetic retinopathy or macular oedema using the International Clinical Diabetic Retinopathy Severity Scale and the International Clinical Diabetic Macular Oedema Severity scale, respectively.
Two hundred and fourteen eyes from 107 subjects were examined during the study period, all of whom had type 2 diabetes mellitus. Diabetic retinopathy was present in 53.3% (114/214) of eyes, with 14.5% having proliferative retinopathy and 7.5% with severe non-proliferative retinopathy. Also, 25.2% (54/214) had some evidence of macular oedema with 11.7% (25/214) requiring treatment. A statistically significant relationship existed between the length of time since diagnosis and the severity of both retinopathy (p < 0.001) and macular oedema (p = 0.031). Blood pressure more than 150/85 mmHg was associated with higher levels of diabetic retinopathy (p = 0.03) and macular oedema (p = 0.02).
A comprehensive diabetic retinopathy screening programme is much needed in Samoa given the high prevalence of diabetic eye disease.
本研究的目的是通过试点视网膜摄影筛查项目来确定萨摩亚糖尿病视网膜病变的患病率。
我们对2011年5月至2011年9月期间前往萨摩亚阿皮亚图普阿·塔马塞塞·梅阿奥莱眼科诊所就诊的糖尿病患者进行了横断面研究。该研究获得了萨摩亚国家卫生服务委员会、莫纳什大学人类研究伦理委员会的批准，并遵循了《赫尔辛基宣言》的原则。在获得知情同意后，数据收集包括患者人口统计学信息（年龄、居住地区（农村或城市））、糖尿病类型、诊断后的时间长度、最近的随机血糖和血压水平。使用佳能CR6 - 45NM相机为受试者的每只眼睛拍摄三张45度的视网膜照片。所有可分级的照片分别使用国际临床糖尿病视网膜病变严重程度量表和国际临床糖尿病黄斑水肿严重程度量表评估是否存在糖尿病视网膜病变或黄斑水肿。
在研究期间检查了107名受试者的214只眼睛，所有受试者均患有2型糖尿病。53.3%（114/214）的眼睛存在糖尿病视网膜病变，其中14.5%患有增殖性视网膜病变，7.5%患有严重非增殖性视网膜病变。此外，25.2%（54/214）有黄斑水肿的一些证据，11.7%（25/214）需要治疗。诊断后的时间长度与视网膜病变的严重程度（p < 0.001）和黄斑水肿的严重程度（p = 0.031）之间存在统计学上的显著关系。血压高于150/85 mmHg与更高水平的糖尿病视网膜病变（p = 0.03）和黄斑水肿（p = 0.02）相关。
鉴于糖尿病眼病的高患病率，萨摩亚急需一个全面的糖尿病视网膜病变筛查项目。
