el Haddad O A, Saad M K
Department of Ophthalmology, Al Buraimi Hospital, Sultanate of Oman.
Br J Ophthalmol. 1998 Aug;82(8):901-6. doi: 10.1136/bjo.82.8.901.
To study the prevalence of diabetic retinopathy in a population of patients attending a diabetic clinic and to evaluate the medical risk factors underlying its development.
500 randomly selected diabetic patients attending the diabetes clinic in Al Buraimi hospital were referred to the ophthalmology department where they were fully evaluated for the absence or presence of retinopathy. Any retinopathy present was graded as mild non-proliferative retinopathy (NPR), moderate-severe NPR, and proliferative retinopathy. Several risk factors were then evaluated in order to delineate those related to occurrence of retinopathy in general as well as to the different grades of retinopathy in particular.
Diabetic retinopathy was detected in 212 patients (42.4%), with mild NPR present in 128 patient (25.6% of the total population), moderate-severe NPR in 20 patients (4%), and proliferative diabetic retinopathy present in 64 patients (12.8%). Factors significantly related to occurrence of retinopathy were age of the patient, duration of diabetes, presence of ischaemic heart disease, presence of hypertension, a high fasting capillary glucose level as well as elevated serum levels of urea, creatinine, cholesterol, and triglycerides. After adjustment for covariates, it was found that duration of diabetes was the only risk factor associated with mild NPR, while high diastolic blood pressure and high levels of serum creatinine, cholesterol, and triglycerides were significantly associated with the occurrence of proliferative retinopathy.
In addition to glycaemic control, lowering of blood lipids as well as diastolic blood pressure (in hypertensive patients) may be effective in lowering the incidence of retinopathy in compromised patients.
研究在糖尿病门诊就诊的患者中糖尿病视网膜病变的患病率，并评估其发生的医学风险因素。
随机选取500名在布赖米医院糖尿病门诊就诊的糖尿病患者，转诊至眼科进行全面评估，以确定是否存在视网膜病变。存在的任何视网膜病变被分为轻度非增殖性视网膜病变（NPR）、中度至重度NPR和增殖性视网膜病变。然后评估了几个风险因素，以确定那些与视网膜病变的发生总体相关，特别是与不同等级视网膜病变相关的因素。
在212名患者（42.4%）中检测到糖尿病视网膜病变，其中128名患者存在轻度NPR（占总人口的25.6%），20名患者存在中度至重度NPR（4%），64名患者存在增殖性糖尿病视网膜病变（12.8%）。与视网膜病变发生显著相关的因素包括患者年龄、糖尿病病程、缺血性心脏病的存在、高血压的存在、空腹毛细血管血糖水平升高以及血清尿素、肌酐、胆固醇和甘油三酯水平升高。在对协变量进行调整后，发现糖尿病病程是与轻度NPR相关的唯一风险因素，而高舒张压以及血清肌酐、胆固醇和甘油三酯水平升高与增殖性视网膜病变的发生显著相关。
除了血糖控制外，降低血脂以及（高血压患者的）舒张压可能有效降低受损患者视网膜病变的发生率。
