Klein B E, Klein R, Moss S E
Department of Ophthalmology and Visual Sciences, University of Wisconsin Medical School, Madison, USA.
Br J Ophthalmol. 1997 Sep;81(9):743-7. doi: 10.1136/bjo.81.9.743.
To determine the incidence of self reported glaucoma in a group of people with diabetes mellitus.
In an 11 county area in southern Wisconsin, a cohort of people with diabetes mellitus was identified and characterised by history, physical examination, fundus photographs, and laboratory evaluation in 1980-2 (n = 2366). The cohort was followed for 10 years with 891 younger onset and 987 older onset people participating in at least one follow up examination.
The 10 year incidence of glaucoma was 3.7% in younger onset people, 6.9% in older onset people not using insulin, and 11.8% in older onset people using insulin. Univariate analyses revealed that in younger onset people greater body mass index, older age, longer duration of diabetes, history of cataract surgery, and increased severity of diabetic retinopathy at baseline conferred increased risk. In older onset people using insulin, older age and longer duration of diabetes, higher intraocular pressure, and history of cataract surgery at baseline were associated with increased risk of glaucoma. In multivariate analyses, only age was significantly related to increased incidence in younger onset people and age, intraocular pressure, and insulin use were significantly associated with increased risk in the older onset group.
Most risk factors associated with self reported glaucoma in people with diabetes cannot currently be modified to decrease incidence. Older onset people who are at increased risk of many ocular complications of diabetes may be particularly in need of specialised ophthalmic observation.
确定一组糖尿病患者中自我报告的青光眼发病率。
在威斯康星州南部的一个11县地区,于1980 - 1982年确定了一组糖尿病患者,并通过病史、体格检查、眼底照片和实验室评估对其进行特征描述(n = 2366)。该队列随访了10年,891名发病较早者和987名发病较晚者至少参加了一次随访检查。
发病较早者青光眼的10年发病率为3.7%,未使用胰岛素的发病较晚者为6.9%,使用胰岛素的发病较晚者为11.8%。单因素分析显示,在发病较早者中,较高的体重指数、年龄较大、糖尿病病程较长、白内障手术史以及基线时糖尿病视网膜病变严重程度增加会增加患病风险。在使用胰岛素的发病较晚者中,年龄较大、糖尿病病程较长、眼压较高以及基线时的白内障手术史与青光眼风险增加有关。多因素分析中,只有年龄与发病较早者发病率增加显著相关,而在发病较晚组中,年龄、眼压和胰岛素使用与风险增加显著相关。
目前,大多数与糖尿病患者自我报告的青光眼相关的危险因素无法通过改变来降低发病率。糖尿病多种眼部并发症风险增加的发病较晚者可能尤其需要专门的眼科观察。