Thapa Raba, Twyana Shankha N, Paudyal Govinda, Khanal Shankar, van Nispen Ruth, Tan Stevie, Thapa Suman S, van Rens Ghmb
Vitreo-retina Department, Tilganga Institute of Ophthalmology, Kathmandu, Nepal.
Department of Eye Bank, Tilganga Institute of Ophthalmology, Kathmandu, Nepal.
Clin Ophthalmol. 2018 Mar 23;12:561-568. doi: 10.2147/OPTH.S157560. eCollection 2018.
Diabetic retinopathy (DR) is an emerging cause of blindness in developing countries. This study aimed to explore the prevalence and risk factors of DR in an elderly population in Nepal.
This is a population-based, cross-sectional study. A total of 1860 subjects at the age 60 years and above participated (response rate 88.6%). A detailed history was obtained, presenting and best-corrected visual acuity were measured, and anterior segment and posterior segment examinations were carried out. Blood pressure and random blood sugar were recorded; body mass index was calculated, and abdominal girth was measured. DR was graded by clinical examination using Early Treatment Diabetic Retinopathy Study criteria.
Diabetes was found in 168 (9%) subjects (mean age 69.6 years), 31 (18.5%) of whom were newly diagnosed. The prevalence of DR was 23.8% (95% confidence interval [CI]: 17.7%-31%) among the persons with diabetes. The prevalence of DR among newly diagnosed subjects with diabetes was 6.5% (95% CI: 0.8%-21.4%). The prevalence of vision-threatening DR was 9.5% (95% CI: 5.5%-15%) and was higher in males. The prevalence of DR was 83.3% (95% CI: 35.9%-99.6%) among those with diabetes for over 20 years. In multivariable logistic regression analysis, duration of diabetes, hypertension, and alcohol consumption were significantly associated with DR.
DR is a common problem among the elderly population with diabetes in Nepal. The duration of diabetes, hypertension, and alcohol consumption are the risk factors for the development of DR. Strategies have to be developed for timely diagnosis of diabetes and screening for DR.
糖尿病视网膜病变（DR）在发展中国家正成为失明的一个新原因。本研究旨在探讨尼泊尔老年人群中DR的患病率及危险因素。
这是一项基于人群的横断面研究。共有1860名60岁及以上的受试者参与（应答率88.6%）。获取详细病史，测量现患视力和最佳矫正视力，并进行眼前节和眼后节检查。记录血压和随机血糖；计算体重指数并测量腹围。根据糖尿病视网膜病变早期治疗研究标准通过临床检查对DR进行分级。
在168名（9%）受试者中发现患有糖尿病（平均年龄69.6岁），其中31名（18.5%）为新诊断病例。糖尿病患者中DR的患病率为23.8%（95%置信区间[CI]：17.7% - 31%）。新诊断的糖尿病受试者中DR的患病率为6.5%（95% CI：0.8% - 21.4%）。威胁视力的DR患病率为9.5%（95% CI：5.5% - 15%），且男性患病率更高。糖尿病病程超过20年的患者中DR患病率为83.3%（95% CI：35.9% - 99.6%）。在多变量逻辑回归分析中，糖尿病病程、高血压和饮酒与DR显著相关。
DR是尼泊尔老年糖尿病患者中的常见问题。糖尿病病程、高血压和饮酒是DR发生的危险因素。必须制定策略以实现糖尿病的及时诊断和DR筛查。
