Porta M, Tomalino M G, Santoro F, Ghigo L D, Cairo M, Aimone M, Pietragalla G B, Passera P, Montanaro M, Molinatti G M
Institute of Internal Medicine, University of Turin, Italy.
Diabet Med. 1995 Apr;12(4):355-61. doi: 10.1111/j.1464-5491.1995.tb00492.x.
Diabetes is known to be a major contributor to blindness in industrialized countries but few data are available on the situation in Italy. As an introductory step to the implementation of permanent screening for diabetic retinopathy, a search was carried out on the causes of visual loss in the provincial territory surrounding Turin, the main city of North-West Italy. The case notes of all 4549 residents in the province who were certified blind between 1967 and 1991 were examined with regard to cause, age at onset, and year of onset of visual acuity < or = 1/20. Diabetic retinopathy was the second commonest cause of bilateral blindness (13.1% of cases), preceded by cataract (26.7%) and followed by myopia (11.1%), optic atrophy (8.9%), glaucoma (8.9%), retinitis pigmentosa (7.2%), and senile macular degeneration (4.1%). Diabetic retinopathy was the commonest eye disease among those who became blind between the ages of 50 and 70 and remained the leading cause of visual loss when the age groups 20 to 70 were pooled together. The incidence of diabetic retinopathy-related blindness did not show any trend to decrease over the 25 years investigated. It is concluded that, in spite of widespread availability of facilities for its assessment and treatment, diabetic retinopathy remains a leading cause of blindness in North-West Italy. This fully justifies the implementation of screening programmes and efficient referral chains for the early detection and prompt treatment of this complication of diabetes.
在工业化国家，糖尿病是导致失明的主要原因之一，但关于意大利的情况，可用数据很少。作为对糖尿病视网膜病变进行长期筛查的初步措施，我们对意大利西北部主要城市都灵周边省份的视力丧失原因进行了调查。我们查阅了该省1967年至1991年间所有4549名被确诊失明居民的病历，了解其失明原因、发病年龄以及视力≤1/20的发病年份。糖尿病视网膜病变是双侧失明的第二大常见原因（占病例的13.1%），排在白内障（26.7%）之后，近视（11.1%）、视神经萎缩（8.9%）、青光眼（8.9%）、色素性视网膜炎（7.2%）和老年性黄斑变性（4.1%）之前。糖尿病视网膜病变是50至70岁失明人群中最常见的眼病，在20至70岁年龄组合并统计时，它仍然是视力丧失的主要原因。在调查的25年中，糖尿病视网膜病变相关失明的发生率没有任何下降趋势。结论是，尽管有广泛的评估和治疗设施，但糖尿病视网膜病变仍然是意大利西北部失明的主要原因之一。这充分说明了实施筛查计划和有效的转诊链以早期发现和及时治疗糖尿病这种并发症的合理性。
