John Curtin School of Medical Research, Australian National University, Canberra, Australia.
Department of Ophthalmology, JDW National Referral Hospital, Ministry of Health, Royal Government of Bhutan, Thimphu, Bhutan.
Jpn J Ophthalmol. 2023 May;67(3):287-294. doi: 10.1007/s10384-023-00989-6. Epub 2023 Apr 18.
To determine the prevalence and severity of diabetic retinopathy (DR) at first presentation among diabetic patients attending national vitreoretinal (VR) services in Bhutan STUDY DESIGN: Retrospective cross-sectional study METHODS: We included all diabetic patients in Bhutan who presented for retinal evaluation for the first time over a 3-year period (2013-2016). Data including demography, clinical details, diagnostic tests, and clinical staging of DR were analyzed.
A total of 843 diabetic patients, aged 57.2 ± 12.0 (range 18-86) years, were enrolled. The majority were male (452, 53.6%; cumulative frequency [cf] 391, 46.4%; P = .14) and from urban settings (570, 67.6%; cf 273; 32.4%) and did not have modern schooling (555, 65.8%). Hypertension was the most common systemic comorbidity (501, 59.4%). The prevalence of DR was 42.7%, with mild nonproliferative DR (NPDR) being the most common type (187, 51.9%), followed by moderate NPDR (88, 24.4%) and proliferative DR (45, 12.5%). In addition, 120 patients had clinically significant macular edema (CSME), with a prevalence of 14.2%. Best-corrected visual acuity (BCVA) of 6/60 or worse occurred in 231 eyes (13.7%), and 41 patients (4.86%) had BCVA of 6/60 or worse bilaterally due to DR/CSME. A logistic regression model indicated that the major determinant of DR was the duration of diabetes, the odds rising by 1.27× with each year of disease (P < .0001).
The prevalence of DR, including CSME, was high. Although a national DR screening program is established in Bhutan, there is a need to accelerate health education, community screening, and referral systems to reduce the prevalence of DR and CSME.
确定在不丹国家玻璃体视网膜（VR）服务就诊的首次接受糖尿病视网膜病变（DR）检查的糖尿病患者的 DR 患病率和严重程度。
回顾性横断面研究。
我们纳入了在 3 年期间（2013-2016 年）首次接受视网膜评估的所有不丹糖尿病患者。分析了包括人口统计学、临床详细信息、诊断测试和 DR 临床分期的数据。
共纳入 843 名年龄为 57.2±12.0（范围 18-86）岁的糖尿病患者。大多数为男性（452 名，53.6%；累积频率[cf]391 名，46.4%；P=0.14），来自城市地区（570 名，67.6%；cf 273 名，32.4%），且未接受现代教育（555 名，65.8%）。高血压是最常见的系统性合并症（501 名，59.4%）。DR 的患病率为 42.7%，其中轻度非增殖性 DR（NPDR）最常见（187 名，51.9%），其次是中度 NPDR（88 名，24.4%）和增殖性 DR（45 名，12.5%）。此外，120 名患者患有临床显著黄斑水肿（CSME），患病率为 14.2%。231 只眼（13.7%）的最佳矫正视力（BCVA）为 6/60 或更差，41 名患者（4.86%）因 DR/CSME 而双侧 BCVA 为 6/60 或更差。逻辑回归模型表明，DR 的主要决定因素是糖尿病的病程，每年疾病的几率增加 1.27×（P<0.0001）。
DR，包括 CSME，的患病率很高。尽管不丹已经建立了国家 DR 筛查计划，但仍需要加快健康教育、社区筛查和转诊系统，以降低 DR 和 CSME 的患病率。
