Avanesova T A, Oganezova J G, Anisimova V V, Baeva A B, Miaev D Kh
OOO Liga+, Reutov, Russia.
OOO TMG Podmoskovye, Sergiev Posad, Russia.
Vestn Oftalmol. 2024;140(4):60-67. doi: 10.17116/oftalma202414004160.
Early detection of diabetic retinopathy (DR) is an urgent ophthalmological problem in Russia and globally.
This study assesses the prevalence of asymptomatic retinopathy and attempts to identify risk groups for its development in patients with type 1 and 2 diabetes mellitus (T1DM and T2DM).
The study involved clinics from 5 cities in the Russian Federation and it included 367 patients with DM, 34.88% men and 65.12% women, aged 50.88±20.55 years. 34.88% of patients suffered from T1DM, 65.12% suffered from T2DM, the average duration of the disease was 9.02±7.22 years. 58.31% of patients had a history of arterial hypertension, 13.08% had a history of smoking. The primary endpoint was the frequency of detection of diabetic changes in the eye fundus of patients with T1DM and T2DM in general; the secondary endpoint - same but separately, and for T2DM patients depending on the duration of the disease. The exploratory endpoint was the assessment of the influence of various factors on the development of DR. The patients underwent visometry (modified ETDRS table), biomicroscopy, mydriatic fundus photography according to the «2 fields» protocol.
The average detection rate of DR was 12.26%, primarily observed in patients with T2DM (13.81%), women (9.26%), in both eyes (8.17%). Among patients with DR, 26 (19.55%) had glycated hemoglobin (HbA1c) level exceeding 7.5% (=0.002), indicating a direct relationship between this indicator and the incidence of DR. Logistic regression analysis showed that the duration of diabetes of more than 10 years has a statistically significant effect on the development of DR. In the modified model for odds estimation, the likelihood of developing DR is increased by the duration of DM for more than 10 years; increased blood pressure; HbA1c level >7.5%.
The obtained results, some of which will be presented in subsequent publications, highlight the effectiveness of using two-field mydriatic fundus photography as a screening for DR.
在俄罗斯乃至全球，糖尿病视网膜病变（DR）的早期检测都是一个紧迫的眼科问题。
本研究评估无症状视网膜病变的患病率，并试图确定1型和2型糖尿病（T1DM和T2DM）患者中其发生的风险组。
该研究涉及俄罗斯联邦5个城市的诊所，纳入了367例糖尿病患者，男性占34.88%，女性占65.12%，年龄为50.88±20.55岁。34.88%的患者患有T1DM，65.12%患有T2DM，疾病平均病程为9.02±7.22年。58.31%的患者有动脉高血压病史，13.08%有吸烟史。主要终点是T1DM和T2DM患者眼底糖尿病性改变的总体检出频率；次要终点——同样是总体检出频率，但分别针对T2DM患者，并根据疾病病程进行分析。探索性终点是评估各种因素对DR发生的影响。患者接受了视力测量（改良ETDRS表）、生物显微镜检查、按照“2视野”方案进行的散瞳眼底摄影。
DR的平均检出率为12.26%，主要见于T2DM患者（13.81%）、女性（9.26%）、双眼患者（8.17%）。在DR患者中，26例（19.55%）糖化血红蛋白（HbA1c）水平超过7.5%（P = 0.002），表明该指标与DR发病率之间存在直接关系。逻辑回归分析表明，糖尿病病程超过10年对DR的发生有统计学显著影响。在改良的比值估计模型中，糖尿病病程超过10年、血压升高、HbA1c水平>7.5%会增加发生DR的可能性。
所获得的结果（其中一些将在后续出版物中呈现）突出了使用双视野散瞳眼底摄影作为DR筛查方法的有效性。
