Fernando D J, Siribaddana S, Subasinge Z
Sri Jayawardenepura General Hospital, Nugegoda, Sri Lanka.
Ceylon Med J. 1993 Sep;38(3):120-3.
To determine the prevalence of diabetic retinopathy among patients with non-insulin dependent diabetes (NIDDM) attending a Sri Lankan diabetes clinic and assess the skills of non-ophthalmologist in screening for retinal disease.
One thousand and three consecutive diabetic patients were screened for diabetic eye disease using a standardised technique based on the WHO Multinational Study.
31.3% (95% confidence intervals 28.0% to 31.6%) had retinopathy, 23% (95% confidence intervals 21% to 25%) had cataract and 20% (95% confidence intervals 17% to 23%) had previously undetected refraction errors. 4.1% (95% confidence intervals 2.1% to 6.0%) of patients were blind due to advanced retinal disease while 6.2% (95% confidence intervals 5.0% to 7.2%) were blind as a result of cataract. General physicians had a 90.6% sensitivity and 100% specificity in screening for retinal disease.
Retinopathy accounts for significant visual handicap. Untreated cataract is more commonly associated with blindness. Undiagnosed errors of refraction account for significant visual handicap in Sri Lankan diabetic patients. Physicians trained in techniques of retinal screening can correctly assess diabetic retinal changes in a high proportion of patients.
确定在一家斯里兰卡糖尿病诊所就诊的非胰岛素依赖型糖尿病（NIDDM）患者中糖尿病视网膜病变的患病率，并评估非眼科医生筛查视网膜疾病的技能。
采用基于世界卫生组织多国研究的标准化技术，对1003例连续的糖尿病患者进行糖尿病眼病筛查。
31.3%（95%置信区间28.0%至31.6%）患有视网膜病变，23%（95%置信区间21%至25%）患有白内障，20%（95%置信区间17%至23%）有先前未被发现的屈光不正。4.1%（95%置信区间2.1%至6.0%）的患者因晚期视网膜疾病失明，6.2%（95%置信区间5.0%至7.2%）因白内障失明。普通内科医生在筛查视网膜疾病时的敏感度为90.6%，特异度为100%。
视网膜病变导致严重视力障碍。未经治疗的白内障更常与失明相关。未诊断出的屈光不正导致斯里兰卡糖尿病患者出现严重视力障碍。接受过视网膜筛查技术培训的医生能够在很大比例的患者中正确评估糖尿病视网膜病变情况。
