Prevalence and risk factors of diabetic retinopathy among an elderly population with diabetes in Nepal: the Bhaktapur Retina Study.
Prevalence and risk factors of diabetic retinopathy among an elderly population with diabetes in Nepal: the Bhaktapur Retina Study.
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DOI：
10.2147/opth.s157560
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发表时间：
2018
期刊：
影响因子：
--
通讯作者：
van Rens G
中科院分区：
文献类型：
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作者：
Thapa R;Twyana SN;Paudyal G;Khanal S;van Nispen R;Tan S;Thapa SS;van Rens G
糖尿病视网膜病变（DR）是发展中国家的一种新的致盲原因。本研究旨在探讨尼泊尔老年人群DR的患病率和危险因素。这是一项基于人群的横断面研究。共有1860例年龄在60岁及以上的受试者参与（应答率88.6%）。详细询问病史，测量当前视力和最佳矫正视力，并进行眼前节和后节检查。记录血压和随机血糖，计算体重指数，测量腹围。采用早期治疗糖尿病视网膜病变研究标准，通过临床检查对DR进行分级。在168例（9%）受试者（平均年龄69.6岁）中发现糖尿病，其中31例（18.5%）为新诊断。糖尿病患者DR患病率为23.8%（95%可信区间[CI]：17.7%~ 31%）。新诊断的糖尿病受试者中DR的患病率为6.5%（95%CI：0.8%-21.4%）。威胁视力的DR的患病率为9.5%（95% CI：5.5%-15%），男性患病率更高。糖尿病病程20年以上者DR患病率为83.3%（95%CI：35.9%~ 99.6%）。在多变量logistic回归分析中，糖尿病持续时间、高血压和饮酒与DR显著相关。DR是尼泊尔老年糖尿病患者的常见问题。糖尿病病程、高血压和饮酒是DR发生的危险因素，必须制定及时诊断糖尿病和筛查DR的策略。
Diabetic retinopathy (DR) is an emerging cause of blindness in developing countries. This study aimed to explore the prevalence and risk factors of DR in an elderly population in Nepal. This is a population-based, cross-sectional study. A total of 1860 subjects at the age 60 years and above participated (response rate 88.6%). A detailed history was obtained, presenting and best-corrected visual acuity were measured, and anterior segment and posterior segment examinations were carried out. Blood pressure and random blood sugar were recorded; body mass index was calculated, and abdominal girth was measured. DR was graded by clinical examination using Early Treatment Diabetic Retinopathy Study criteria. Diabetes was found in 168 (9%) subjects (mean age 69.6 years), 31 (18.5%) of whom were newly diagnosed. The prevalence of DR was 23.8% (95% confidence interval [CI]: 17.7%–31%) among the persons with diabetes. The prevalence of DR among newly diagnosed subjects with diabetes was 6.5% (95% CI: 0.8%–21.4%). The prevalence of vision-threatening DR was 9.5% (95% CI: 5.5%–15%) and was higher in males. The prevalence of DR was 83.3% (95% CI: 35.9%–99.6%) among those with diabetes for over 20 years. In multivariable logistic regression analysis, duration of diabetes, hypertension, and alcohol consumption were significantly associated with DR. DR is a common problem among the elderly population with diabetes in Nepal. The duration of diabetes, hypertension, and alcohol consumption are the risk factors for the development of DR. Strategies have to be developed for timely diagnosis of diabetes and screening for DR.