Agroiya Puspalata, Alrawahi Abdul Hakeem
National Diabetes and Endocrine Centre, Royal Hospital, Seeb, Muscat, Oman.
Department of Research and Studies, Oman Medical Specialty Board, Muscat, Oman.
Middle East Afr J Ophthalmol. 2020 Jan 29;26(4):189-195. doi: 10.4103/meajo.MEAJO_208_19. eCollection 2019 Oct-Dec.
The aim of this study is to describe the prevalence and clinical profile of pediatric diabetic retinopathy (DR) among Omani diabetic children and adolescents attending a tertiary care hospital.
This retrospective cross-sectional study involved the record review of 216 diabetic children attending the diabetes retina clinic of the National Diabetes and Endocrine Centre in the period between June 2015 and November 2018. The retinal evaluation was conducted using direct ophthalmological examination and fundus photography. DR was graded using the Early Treatment DR Study criteria. The statistical analysis was performed using SPSS, version 20.
The prevalence of DR among the study sample was 3.7% (95% confidence interval: 1.2-6.2). Mild and moderate nonproliferative diabetic retinopathy was seen in 2.8% (6) and 0.9% (2) of patients, respectively. Diabetic maculopathy was observed in 2 (0.9%) cases. Diabetic ketoacidosis was seen in 33.8% of children at presentation. DR was significantly associated with age ( = 0.01), duration ( < 0.001), Type 1 diabetes mellitus ( = 0.01), dyslipidemia ( = 0.005), microalbuminuria ( = 0.001), glycated hemoglobin ( = 0.003), total cholesterol ( = 0.001), high-density lipoproteins ( = 0.001), low-density lipoproteins ( < 0.001), and albumin/creatinine ratio ( < 0.001).
This is the first study describing DR among the pediatric age group in Oman. This study reveals a relatively low prevalence of DR and maculopathy among the pediatric diabetic population. However, novel strategies are to be adopted at primary levels to achieve timely screening of diabetic children to enhance the early detection of DR.
本研究旨在描述在一家三级护理医院就诊的阿曼糖尿病儿童和青少年中儿童糖尿病视网膜病变(DR)的患病率及临床特征。
这项回顾性横断面研究涉及对2015年6月至2018年11月期间在国家糖尿病与内分泌中心糖尿病视网膜诊所就诊的216例糖尿病儿童的病历进行审查。使用直接眼科检查和眼底摄影进行视网膜评估。采用早期治疗糖尿病视网膜病变研究标准对DR进行分级。使用SPSS 20版进行统计分析。
研究样本中DR的患病率为3.7%(95%置信区间:1.2 - 6.2)。轻度和中度非增殖性糖尿病视网膜病变分别见于2.8%(6例)和0.9%(2例)的患者。观察到2例(0.9%)患有糖尿病性黄斑病变。就诊时33.8%的儿童出现糖尿病酮症酸中毒。DR与年龄(P = 0.01)、病程(P < 0.001)、1型糖尿病(P = 0.01)、血脂异常(P = 0.005)、微量白蛋白尿(P = 0.001)、糖化血红蛋白(P = 0.003)、总胆固醇(P = 0.001)、高密度脂蛋白(P = 0.001)、低密度脂蛋白(P < 0.001)以及白蛋白/肌酐比值(P < 0.001)显著相关。
这是第一项描述阿曼儿童年龄组中DR情况的研究。本研究揭示了儿童糖尿病患者中DR和黄斑病变的患病率相对较低。然而,应在初级层面采用新策略,以便及时筛查糖尿病儿童,加强DR的早期检测。