Belfast Ophthalmic Reading Centre, Centre for Public Health, Queen's University Belfast, Belfast, UK.
Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G d'Annunzio Chieti-Pescara, Chieti, Italy.
BMJ Open Diabetes Res Care. 2021 Sep;9(1). doi: 10.1136/bmjdrc-2021-002267.
This study investigated Northern Ireland Diabetic Eye Screening Programme (NIDESP) attendance and diabetic retinopathy (DR) prevalence/severity in patients with diabetes mellitus secondary to chronic pancreatitis (PwDMsCP).
Medical/NIDESP records for all PwDMsCP attending the pancreatic diabetes clinic were analyzed in 2017 (n=78) and 2019 (n=94).
Between 2017 and 2019, those without DR decreased (76% to 63%); mild non-proliferative DR (NPDR), severe NPDR and PDR were found in 30%, 2% and 5%, respectively (previously 18%, 4%, 2%); diabetic maculopathy (DMac) was present in 12% (previously 10%). There was no significant difference between worst-eye DR/DMac grade and HbA1c, gender, body mass index, pancreatitis etiology and screening attendance (p>0.05). Patients with proliferative DR had longer diabetes and pancreatitis duration than DR-free patients (both p=0.001).
DR prevalence was similar in PwDMsCP and patients with type 2 diabetes of similar disease duration. This work demonstrates the importance of reaching all patients for establishing DR severity reliably and to provide accessible, equitable care to PwDMsCP.
本研究调查了因慢性胰腺炎继发糖尿病(PwDMsCP)患者参与北爱尔兰糖尿病眼病筛查计划(NIDESP)的情况以及糖尿病视网膜病变(DR)的患病率/严重程度。
对 2017 年(n=78)和 2019 年(n=94)在胰腺糖尿病诊所就诊的所有 PwDMsCP 的医疗/NIDESP 记录进行了分析。
在 2017 年至 2019 年间,无 DR 的患者比例下降(76%降至 63%);轻度非增生性 DR(NPDR)、重度 NPDR 和 PDR 的检出率分别为 30%、2%和 5%(之前分别为 18%、4%和 2%);糖尿病性黄斑病变(DMac)的检出率为 12%(之前为 10%)。最差眼 DR/DMac 分级与 HbA1c、性别、体重指数、胰腺炎病因和筛查参与率之间无显著差异(p>0.05)。增殖性 DR 患者的糖尿病和胰腺炎病程均长于无 DR 患者(均 p=0.001)。
PwDMsCP 患者的 DR 患病率与病程相似的 2 型糖尿病患者相似。这项工作证明了为所有患者建立可靠的 DR 严重程度并为 PwDMsCP 提供可及、公平的护理的重要性。