Clinical Sciences in Lund, Lund University, Lund, Sweden.
Department of Endocrinology, Skåne University Hospital, Lund, Sweden.
Diabet Med. 2018 Oct;35(10):1364-1370. doi: 10.1111/dme.13682. Epub 2018 Aug 2.
To clarify the frequency and severity of diabetic retinopathy in a group of people with Type 2 diabetes and chronic diabetic foot ulcers, and to compare visual acuity, levels of retinopathy and clinical significant macular oedema with a matched control group of people with Type 2 diabetes without a history of chronic diabetic foot ulcers.
Visual acuity and fundus imaging were evaluated in 90 white people with at least 3 months' duration of full-thickness diabetic foot ulcers below the ankle and the results compared with those in 180 white people with Type 2 diabetes without a history of chronic diabetic foot ulcers (control group). Controls were matched for age, sex and duration of diabetes.
Despite similar age and diabetes duration, severe non-proliferative or proliferative diabetic retinopathy was present in 41% of the people in the diabetic foot ulcer group as compared to 15% in the control group (P<0.001). Only 6% in the diabetic foot ulcer group was without any diabetic retinopathy as compared to 34% among controls. Proliferative diabetic retinopathy was more common in the diabetic foot ulcer group (31% vs 8%; P<0.001), but time-to-proliferative diabetic retinopathy did not differ between groups. Clinically significant macular oedema was more frequently present, and the diabetic foot ulcer group exhibited significantly worse results in best and worst eye visual acuity testing.
In this northern European setting almost all people with Type 2 diabetes and chronic diabetic foot ulcers had diabetic retinopathy. Almost one-third had proliferative diabetic retinopathy as compared to <10% in our matched control group. More advanced diabetic retinopathy was linked to worse visual acuity.
明确患有 2 型糖尿病及慢性糖尿病足溃疡人群中糖尿病视网膜病变的频率和严重程度，并与无慢性糖尿病足溃疡病史的 2 型糖尿病匹配对照组人群的视力、视网膜病变程度和临床显著黄斑水肿水平进行比较。
评估了 90 名至少患有 3 个月全层糖尿病足溃疡的白人患者的视力和眼底图像，并将结果与 180 名无慢性糖尿病足溃疡病史的白人 2 型糖尿病患者（对照组）进行比较。对照组在年龄、性别和糖尿病病程方面相匹配。
尽管年龄和糖尿病病程相似，但在糖尿病足溃疡组中，41%的人患有严重的非增殖性或增殖性糖尿病视网膜病变，而对照组中仅有 15%（P<0.001）。糖尿病足溃疡组中仅有 6%的人没有任何糖尿病视网膜病变，而对照组中有 34%。增殖性糖尿病视网膜病变在糖尿病足溃疡组中更为常见（31% vs 8%；P<0.001），但两组之间增殖性糖尿病视网膜病变的发生时间并无差异。临床显著黄斑水肿更为常见，且糖尿病足溃疡组的最佳和最差视力测试结果明显更差。
在这个北欧环境中，几乎所有患有 2 型糖尿病及慢性糖尿病足溃疡的人都患有糖尿病视网膜病变。与我们的匹配对照组中<10%的人相比，近三分之一的人患有增殖性糖尿病视网膜病变。更严重的糖尿病视网膜病变与更差的视力相关。
