加纳部分选定医疗机构中糖尿病患儿和青少年眼部变化的横断面研究。
A Cross-Sectional Study of Ocular Changes in Children and Adolescents with Diabetes Mellitus in Selected Health Facilities in Ghana.
机构信息
Ophthalmology Unit, Department of Surgery, University of Ghana Medical School, University of Ghana, Accra P.O. Box GP 4236, Ghana.
Eye Department, Korle Bu Teaching Hospital, Accra P.O. Box 77, Ghana.
出版信息
Int J Environ Res Public Health. 2022 Apr 27;19(9):5295. doi: 10.3390/ijerph19095295.
BACKGROUND
The main objective of the study was to determine the prevalence of diabetic retinopathy (DR), other diabetes-related ocular changes (e.g., cataracts, corneal ulceration), and non-diabetic ocular disease in Ghanaian children and adolescents. The second objective was to evaluate the relationship between these conditions and age at diagnosis, current age, diabetes mellitus (DM) duration, and participant's sex.
METHODS
A cross-sectional study, undertaken by a multidisciplinary team, included a cohort of children and adolescents (4-19 years) with DM recruited from selected health facilities in Ghana, from March 2016 to September 2019, after written informed consent or assent. The cohort will be followed up for 3 years to determine the natural course of the ocular changes, reported later. Participants were examined for all microvascular and macrovascular complications, non-diabetic ocular disease, anthropometric measurements, laboratory characteristics and quality of life issues. Full ocular examination was also undertaken. Statistical Package for Social Sciences (SPSS Version 25.0) was used for the data analysis. Continuous and categorical variables were presented as mean and standard deviation (SD), median (interquartile range) and as percentages (%), respectively. T-test and Mann-Whitney U test were used in establishing associations.
RESULTS
A total of 58 participants were recruited. DR was detected in only 1 out of 58 (1.7%) participants at baseline. Cataracts were the most common ocular finding, detected in 42 (72%) at baseline. Other anterior segment changes observed included blepharitis 46 (79.3%) and tear film instability 38 (65.5%). There was a significant positive association between duration of the DM and the risk of cataract ( = 0.027). Participants' age at diagnosis was significantly associated with the presence of prominent corneal nerves ( = 0.004).
CONCLUSIONS
DR was uncommon in this cohort of young persons with DM in Ghana. Cataracts, blepharitis and refractive errors were ocular changes commonly observed. All young persons with diabetes should undergo regular eye examination in all clinics where follow-up care is provided.
背景
本研究的主要目的是确定加纳儿童和青少年中糖尿病视网膜病变（DR）、其他与糖尿病相关的眼部变化（如白内障、角膜溃疡）和非糖尿病性眼病的患病率。第二个目的是评估这些情况与诊断时的年龄、当前年龄、糖尿病（DM）持续时间以及参与者的性别之间的关系。
方法
这是一项横断面研究，由一个多学科团队进行，纳入了 2016 年 3 月至 2019 年 9 月期间从加纳选定的医疗机构招募的患有 DM 的儿童和青少年（4-19 岁）队列，在获得书面知情同意或同意后进行。该队列将被随访 3 年，以确定眼部变化的自然病程，随后将报告。对参与者进行了所有微血管和大血管并发症、非糖尿病性眼病、人体测量测量、实验室特征和生活质量问题的检查。还进行了全面的眼部检查。使用社会科学统计软件包（SPSS 版本 25.0）进行数据分析。连续变量和分类变量分别以平均值和标准差（SD）、中位数（四分位距）和百分比（%）表示。使用 t 检验和曼-惠特尼 U 检验来确定关联。
结果
共纳入 58 名参与者。仅在基线时发现 58 名参与者中的 1 名（1.7%）患有 DR。白内障是最常见的眼部发现，基线时发现 42 例（72%）。观察到的其他前节变化包括睑缘炎 46 例（79.3%）和泪膜不稳定 38 例（65.5%）。DM 持续时间与白内障风险呈显著正相关（ = 0.027）。参与者的诊断年龄与明显的角膜神经存在显著相关（ = 0.004）。
结论
在加纳的这一糖尿病儿童和青少年队列中，DR 并不常见。白内障、睑缘炎和屈光不正常见眼部变化。所有接受糖尿病治疗的年轻人都应在所有提供随访护理的诊所定期进行眼部检查。
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