Parnes R E, Singerman L J
Retinal Institute, Mt. Sinai Medical Center, Cleveland.
J Fla Med Assoc. 1994 Apr;81(4):236-9.
Diabetic retinopathy is a major cause of morbidity and the leading cause of legal blindness in working-age persons in the United States. Retinopathy affects both juvenile-onset and noninsulin dependent diabetics. Most visual loss occurs in patients because they are seen late in the course of their disease. Several clinical trials have aided in establishing recommended screening and referral guidelines for patients with diabetes mellitus. Treatment strategies based on clinical trials are reviewed as well as the importance of control of both hyperglycemia and hypertension. Ocular findings are illustrated and discussed. The primary care physician can substantially reduce the risk of blindness and visual impairment in diabetic patients by prompt recognition of the ocular findings and understanding the importance of timely ophthalmologic evaluation.
糖尿病视网膜病变是美国发病的主要原因，也是劳动年龄人群法定失明的首要原因。视网膜病变影响青少年发病型糖尿病患者和非胰岛素依赖型糖尿病患者。大多数视力丧失发生在患者身上，是因为他们在疾病过程中就诊较晚。几项临床试验有助于为糖尿病患者建立推荐的筛查和转诊指南。本文回顾了基于临床试验的治疗策略以及控制高血糖和高血压的重要性。文中还举例说明了眼部检查结果并进行了讨论。初级保健医生通过及时识别眼部检查结果并了解及时进行眼科评估的重要性，可大幅降低糖尿病患者失明和视力损害的风险。
