新西兰奥克兰地区糖尿病患者发生可转诊的糖尿病眼病进展的危险因素：一项为期 12 年的回顾性队列分析。

Risk Factors for Progression to Referable Diabetic Eye Disease in People With Diabetes Mellitus in Auckland, New Zealand: A 12-Year Retrospective Cohort Analysis.

机构信息

Ophthalmology Department, Auckland District Health Board, 214 Green Lane West, One Tree Hill, Epsom, Auckland 105, New Zealand.

Ophthalmology Department, University of Auckland, Grafton, Auckland 1023, New Zealand.

出版信息

Asia Pac J Ophthalmol (Phila). 2021;10(6):579-589. doi: 10.1097/APO.0000000000000464.

DOI:10.1097/APO.0000000000000464

PMID:34905518

Abstract

PURPOSE

To evaluate the prevalence and risk factors for the development of any and referable diabetic eye disease in a multi-ethnic New Zealand population with diabetes mellitus attending a regional retinal screening service.

METHODS

Retrospective observational cohort study of people living with diabetes who attended the Auckland Regional Diabetic Retinal Screening Programme 2006-2018 inclusive (n = 41,786).

RESULTS

Any retinopathy/maculopathy was present at first screening for 48.2% [95% confidence interval (CI): 45.8%-50.6%] / 37.8% (95% CI: 35.5%- 40.1%) of people with Type 1 and 25% (95% CI: 24.6%-25.4%) / 21.9% (95% CI: 21.5%-22.3%) with Type 2 diabetes. Referable retinopathy at baseline screening was 4.4% (95% CI: 3.6%-5.3%) and 1.6% (95% CI: 1.5%-1.7%) among people with Type 1 and Type 2 diabetes mellitus, respectively. After 4 years, cumulative incidence for referable retinopathy /referable maculopathy was 12/36 per 1000 people with Type 1 and 2.4/16 per 1000 people with Type 2 diabetes. Independent hazards for disease progression varied for the diabetes cohort types but baseline grade, duration of diabetes, and HbA1c were common to all.

CONCLUSIONS

Referable diabetic eye disease at the first screening and after 4 years of follow-up is uncommon. Lengthening of the screening intervals for people with no or mild diabetic eye disease at first screening assessment could be considered.

摘要

目的

评估在一个多民族的新西兰糖尿病患者群体中，患有糖尿病并参加区域性视网膜筛查服务的患者中，任何和可归因于糖尿病性眼病的患病率和危险因素。

方法

对 2006 年至 2018 年期间参加奥克兰地区糖尿病视网膜筛查计划的糖尿病患者进行回顾性观察队列研究（n=41786）。

结果

在首次筛查时，48.2%（95%可信区间[CI]：45.8%-50.6%）/37.8%（95% CI：35.5%-40.1%）的 1 型糖尿病患者和 25%（95% CI：24.6%-25.4%）/21.9%（95% CI：21.5%-22.3%）的 2 型糖尿病患者存在任何视网膜病变/黄斑病变。基线筛查时的可归因性视网膜病变为 4.4%（95% CI：3.6%-5.3%）和 1.6%（95% CI：1.5%-1.7%），分别为 1 型和 2 型糖尿病患者。在 4 年后，1 型糖尿病患者的可归因性视网膜病变/可归因性黄斑病变的累积发病率为每 1000 人 12/36 例，2 型糖尿病患者为每 1000 人 2.4/16 例。疾病进展的独立危险因糖尿病患者类型而异，但基线分级、糖尿病病程和糖化血红蛋白适用于所有患者。