Pissarek D, Schoder O
Poliklinik für Innere Medizin, Medizinischen Akademie Erfurt.
Z Gesamte Inn Med. 1988 Dec 1;43(23):662-6.
Among the 9,173 diabetics of the city and the district of Erfurt (4.3% of the population) 37 patients with a proliferative retinopathy (0.4% of all diabetics) were found. The impairment of vision was very different: 9 patients had still a full vision, 7 patients were completely blind and only able for light perception, respectively. On the group average the 3rd degree retinopathy developed after 19 years of diabetes. In comparison to the type 1 diabetics (n = 17) the type 2 diabetics (n = 15) showed the more progressing courses. The period from the appearance of the first ophthalmologically provable retinal changes (R I) up to R III was in these cases about 5 years shorter than in the type 1 diabetics. The cause for the proliferative retinopathy is multifactorial. Our results plead for the fact that among the risk factors for the retinal microangiopathy apart from the duration of the disease the quality of metabolism and the arterial hypertension are decisive determinants both in type 1 and in type 2 diabetics. In order to avoid and to delay, respectively, severe impairments of vision, from the beginning of diabetes metabolism and blood pressure should be stabilized as well as possible and by means of regular short-term ophthalmoscopic controls well-timed light and laser coagulations should be striven for.
在爱尔福特市和区的9173名糖尿病患者中(占人口的4.3%),发现37例增殖性视网膜病变患者(占所有糖尿病患者的0.4%)。视力损害差异很大:9例患者仍有正常视力,7例患者完全失明,仅能感知光线。平均而言,糖尿病19年后出现3级视网膜病变。与1型糖尿病患者(n = 17)相比,2型糖尿病患者(n = 15)病程进展更快。在这些病例中,从首次眼科可证实的视网膜病变(R I)出现到R III的时间比1型糖尿病患者短约5年。增殖性视网膜病变的病因是多因素的。我们的结果表明,在视网膜微血管病变的危险因素中,除了疾病持续时间外,代谢质量和动脉高血压在1型和2型糖尿病患者中都是决定性因素。为了分别避免和延缓严重视力损害,从糖尿病开始就应尽可能稳定代谢和血压,并通过定期短期眼底检查争取适时进行光凝和激光凝固治疗。