Mitchell P, Smith W, Wang J J, Attebo K
Department of Ophthalmology, University of Sydney, NSW, Australia.
Ophthalmology. 1998 Mar;105(3):406-11. doi: 10.1016/S0161-6420(98)93019-6.
This study aimed to determine the prevalence and characteristics of diabetic retinopathy (DR) in a defined older Australian population.
A total of 3654 persons 49 years of age or older, 88% of permanent residents from an urban area west of Sydney, underwent a detailed eye examination. This included detailed medical history, Zeiss stereo retinal photography, fasting blood glucose, and other blood factors. The diagnosis of DR was made clinically and from photographic grading in persons with a history or biochemical evidence of diabetes.
Diabetes was present in 7% (95% confidence interval, 6.2-7.8) of the population. Signs of DR were found in 82 participants (2.3%; 95% confidence interval, 1.9-2.8). The prevalence was 1.7% in persons younger than 60 years of age, 2.4% in persons 60 to 69 years of age, 2.7% in persons 70 to 79 years of age, and 2.3% in persons 80 years of age or older. There was no significant gender difference in prevalence. After adjusting for age, gender, and the duration since diagnosis of diabetes, higher blood glucose was related to the finding of moderate-to-severe retinopathy (Wisconsin levels 4-7) compared to milder retinopathy (Wisconsin levels 1.5-3). No association was found between the presence of any retinopathy and blood glucose, a history of hypertension or elevated blood pressure, body-mass index, blood lipids, creatinine, or coagulation factors.
This Australian study has found similar prevalence rates for DR to a recent U.S. population-based study but lower rates for vision-threatening retinopathy than from clinic-based reports. Previous reports of a relationship between advanced retinopathy and blood glucose were supported. Other than diabetes duration and insulin treatment, no other associations with retinopathy were found.
本研究旨在确定特定澳大利亚老年人群中糖尿病视网膜病变（DR）的患病率及特征。
共有3654名49岁及以上的人员接受了详细的眼部检查，这些人员占悉尼西部一个市区永久居民的88%。检查内容包括详细的病史、蔡司立体视网膜摄影、空腹血糖及其他血液指标。对有糖尿病病史或生化证据的人员，通过临床诊断及摄影分级来诊断DR。
该人群中糖尿病患病率为7%（95%置信区间为6.2 - 7.8）。82名参与者（2.3%；95%置信区间为1.9 - 2.8）发现有DR迹象。60岁以下人群患病率为1.7%，60至69岁人群为2.4%，70至79岁人群为2.7%，80岁及以上人群为2.3%。患病率在性别上无显著差异。在对年龄、性别及糖尿病诊断后的病程进行校正后，与轻度视网膜病变（威斯康星分级1.5 - 3级）相比，血糖水平较高与中重度视网膜病变（威斯康星分级4 - 7级）的发现相关。未发现任何视网膜病变与血糖、高血压病史或血压升高、体重指数、血脂、肌酐或凝血因子之间存在关联。
这项澳大利亚研究发现DR的患病率与近期一项基于美国人群的研究相似，但威胁视力的视网膜病变患病率低于基于诊所报告的结果。先前关于晚期视网膜病变与血糖之间关系的报告得到了支持。除糖尿病病程和胰岛素治疗外，未发现与视网膜病变有其他关联。
