Thomas Rebecca L, Luzio Stephen D, North Rachel V, Banerjee Sanjiv, Zekite Antra, Bunce Catey, Owens David R
Diabetes Research Unit Cymru, Swansea University, Swansea, UK.
School of Optometry and Vision Science, Cardiff University, Cardiff, UK.
BMJ Open. 2017 Jul 18;7(7):e015024. doi: 10.1136/bmjopen-2016-015024.
The aim of this study was to analyse the changes in new certifications for both sight impairment (SI) and severe sight impairment (SSI, blindness) in Wales due to diabetic retinopathy (DR)/maculopathy between 2007 and 2015.
This is a retrospective analysis of annual data of new certifications for visual impairment and blindness (Certificate of Vision Impairment) for England and Wales derived from the national database provided by the Certifications Office, Moorfields Eye Hospital, over a period of 8 years from 2007.
In Wales there were 339 less new certifications for both SI and severe SSI from any cause combined from 2007-2008 to 2014-2015. The number SI and SSI combined specifically due to DR was reduced by 22 in people with known diabetes. This was a reduction in new certifications over the observation period from 82.4 to 46.9 per 100 000 (-43.1%) with a fall in SSI from 31.3 to 15.8 per 100 000 (-49.4%), respectively. During this observation period however, there was a parallel increase in 52 229 (39.8%) persons with diabetes in Wales.
While acknowledging the limitations of the certification process and the increasing numbers of persons with diabetes, the incidence of SI and SSI per 100 000 population of persons with diabetes in Wales has almost halved over an 8-year period up to 2015. This may reflect the earlier diagnosis of DR and sight-threatening DR since the introduction of screening and/or improved diabetes management with timely onward referral and newer treatments.
本研究旨在分析2007年至2015年间,威尔士因糖尿病视网膜病变(DR)/黄斑病变导致的视力损害(SI)和严重视力损害(SSI,失明)新认证情况的变化。
这是一项回顾性分析,数据来源于摩尔菲尔德眼科医院认证办公室提供的国家数据库,涉及2007年起8年间英格兰和威尔士视力损害和失明(视力损害证书)的年度新认证数据。
在威尔士,从2007 - 2008年到2014 - 2015年,任何原因导致的SI和严重SSI新认证总数减少了339例。已知糖尿病患者中,单纯因DR导致的SI和SSI合并数减少了22例。在观察期内,新认证率从每10万人82.4例降至46.9例(-43.1%),SSI从每10万人31.3例降至15.8例(-49.4%)。然而,在此观察期内,威尔士糖尿病患者人数同时增加了52229人(39.8%)。
尽管认识到认证过程存在局限性以及糖尿病患者人数不断增加,但截至2015年的8年时间里,威尔士每10万糖尿病患者中SI和SSI的发病率几乎减半。这可能反映了自引入筛查和/或改善糖尿病管理(包括及时转诊和采用新治疗方法)以来,DR及威胁视力的DR得到了更早的诊断。