Prevalence of diabetic retinopathy in patients with diabetes mellitus diagnosed after the age of 70 years
Prevalence of diabetic retinopathy in patients with diabetes mellitus diagnosed after the age of 70 years
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DOI：
10.1136/bjo.81.3.218
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发表时间：
1997-03-01
影响因子：
4.1
通讯作者：
Acheson, RW
中科院分区：
文献类型：
--
作者：
Cahill, M;Halley, A;Acheson, RW
目的/背景-一项以医院为基础的患病率研究被用来估计70岁以后被诊断为糖尿病的患者中糖尿病视网膜病变(DR)的患病率。糖尿病诊断时视力威胁视网膜病变的患病率也被确定。研究糖尿病视网膜病变的患病率与糖尿病病程、治疗方式、糖化血红蛋白(1c)水平、高血压的存在和患者性别之间的关系，并将这项研究与早期老年2型糖尿病患者糖尿病视网膜病变的患病率进行比较。方法-利用都柏林Mater Misericordiae医院爱尔兰糖尿病视网膜病变登记的数据，所有70岁后被诊断为II型糖尿病的患者都被邀请参加眼科检查。结果：在150名接受检查的患者中，21名(14%)有某种形式的DR，其中10名(6.6%)有视觉威胁视网膜病变或既往治疗过的视觉威胁视网膜病变。5名患者(3.3%)在诊断糖尿病时出现视觉威胁视网膜病变。有糖尿病视网膜病变的患者的糖尿病病程中位数(5.0年)显著高于无糖尿病视网膜病变的患者(3.5年)。需要胰岛素治疗的糖尿病视网膜病变患者的比例明显较高，而没有糖尿病视网膜病变的患者仅控制饮食的比例相应较低。糖尿病视网膜病变的患病率与HbA(1c)水平、全身性高血压或患者性别之间无显著关联。与早期研究相比，DR的总体患病率较低。结论：这些老年II型糖尿病患者的DR患病率低于CHAT在II型疾病患者中的宝贵报道，但一小部分患者在出现时有视觉威胁的视网膜病变。糖尿病和胰岛素使用时间较长与DR患病率显著增加有关。所有老年II型糖尿病患者在首次出现糖尿病时都需要进行彻底的眼科检查，此后定期检查。
Aims/background-A hospital based prevalence study was undertaken to estimate the prevalence of diabetic retinopathy (DR) in patients diagnosed as having diabetes mellitus after the age of 70 Fears. The prevalence of visually threatening retinopathy at the time of diagnosis of diabetes was also determined. The association between prevalence of DR and duration of diabetes mellitus, mode of treatment, HbA(1c) levels, presence of hypertension, and sex of patient was examined and a comparison was drawn between this study and earlier prevalence studies of DR in older type II diabetics.Methods-Using data on the Irish Diabetic Retinopathy Register located in the Mater Misericordiae Hospital, Dublin, all patients who were diagnosed as having type II diabetes mellitus after the age of 70 years were invited to attend for ophthalmic review. Medical records were examined to determine the duration of diabetes mellitus, mode of treatment, recent HbA(1c) levels, and the presence of systemic hypertension.Results-Of the 150 patients examined, 21 (14%) had some form of DR and 10 of these patients (6.6%) had visually threatening retinopathy or previously treated visually threatening retinopathy. Five patients (3.3%) presented with visually threatening retinopathy at the time of diagnosis of diabetes. Those patients with DR had a significantly higher median duration of diabetes (5.0 years) compared with those patients without DR (3.5 years). A significantly higher proportion of patients with DR required treatment with insulin and a correspondingly lower proportion of patients without DR were controlled on diet alone. There was no significant association between prevalence of DR and HbA(1c) levels, systemic hypertension, or sex of patient. There was a lower overall prevalence of DR in comparison with earlier studies.Conclusions-The prevalence of DR in these elderly type II diabetics is lower than chat preciously reported in patients with type II disease but a small percentage of patients had visually threatening retinopathy at presentation. Longer duration of diabetes and insulin use were associated with a significantly increased prevalence of DR. All elderly type II diabetic patients require thorough ophthalmic examination near to the time of first presentation and thereafter at regular intervals.