Chua Jacqueline, Lim Claire Xin Ying, Wong Tien Yin, Sabanayagam Charumathi
Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.
Ophthalmology and Visual Sciences Academic Clinical Program, Duke-National University of Singapore Medical School, Singapore.
Asia Pac J Ophthalmol (Phila). 2018 Jan-Feb;7(1):3-16. doi: 10.22608/APO.2017511. Epub 2017 Jan 26.
Diabetic retinopathy (DR), the most common complication of diabetes mellitus, is the leading cause of new cases of blindness in middle-aged and elderly in the Asia-Pacific. It has been estimated that 51% of all those with blindness due to DR globally (n = 424,400) and 56% of those with visual impairment due to DR (2.1 million) come from the Asia-Pacific. Prevalence of DR among those with diabetes ranged from 10% in India to 43% in Indonesia within the Asia-Pacific. Awareness of DR among persons with diabetes ranged from 28% to 84%. Most common modifiable risk factors for DR in the Asia-Pacific were hyperglycemia, blood pressure, dyslipidemia, and obesity. Implementation of systematic screening programs for DR and advancement in telemedicine screening methods have increased patient coverage and cost-effectiveness, though there are still numerous factors impeding screening uptake in the low-middle income regions of the Asia-Pacific. Management and treatment of DR in the Asia-Pacific is mainly limited to traditional laser retinopexy, but it is suboptimal despite new clinical approaches such as use of intravitreal anti.vascular endothelial growth factor and steroids due to limited resources. Further research and data are required to structure a more cost-effective public healthcare program and more awareness-building initiatives to increase the effectiveness of DR screening programs.
糖尿病视网膜病变(DR)是糖尿病最常见的并发症,是亚太地区中老年人失明新病例的主要原因。据估计,全球因糖尿病视网膜病变导致失明的患者中,51%(n = 424,400)以及因糖尿病视网膜病变导致视力损害的患者中,56%(210万)来自亚太地区。在亚太地区,糖尿病患者中糖尿病视网膜病变的患病率从印度的10%到印度尼西亚的43%不等。糖尿病患者对糖尿病视网膜病变的知晓率从28%到84%不等。亚太地区糖尿病视网膜病变最常见的可改变危险因素是高血糖、血压、血脂异常和肥胖。糖尿病视网膜病变系统筛查项目的实施以及远程医疗筛查方法的进步提高了患者覆盖率和成本效益,不过在亚太地区的中低收入地区,仍有许多因素阻碍筛查的普及。亚太地区糖尿病视网膜病变的管理和治疗主要限于传统的激光视网膜固定术,但尽管有玻璃体内注射抗血管内皮生长因子和类固醇等新的临床方法,由于资源有限,效果仍不理想。需要进一步的研究和数据来构建一个更具成本效益的公共医疗保健项目,以及更多提高认识的举措,以提高糖尿病视网膜病变筛查项目的有效性。