惠州市糖尿病患者黄斑水肿流行病学调查

目的 调查惠州市患有糖尿病居民中黄斑水肿的患病率,探讨糖尿病黄斑水肿(DME)的严重程度与糖尿病视网膜病变(DR)程度、视力损害和糖尿病病程之间的关系.方法 以自然人群为基础,对惠州市随机抽样进行糖尿病筛查,确诊者进一步进行DME及DR的检查.具体包括问卷调查、视力榆查、裂隙灯显微镜下+90D前置镜检查眼底、眼底彩色照相及眼底荧光血管造影(FFA)检查.结果 糖尿病患者645人中患有DR262人,DME患者92例,惠州市人群DME发病率0.91%,在糖尿病患者人群患病率1.43%,在DR患者中患病率35.1%;轻度DME38.20%,中度DME31.46%,重度DME30.33%;随着DR分期的加重,DME有加重的趋势(r=0.945,P=0.035);患者的视力随着DME的加重明显下降(r=-0.972,P=0.005); DME的分级与糖尿病病程具有显著相关性(r=0.954,P=0.008).结论 DME严重危害糖尿病患者视力,需建立DME患者流行病学资料早期筛查、早期发现合理治疗以降低DME致盲率;DME的严重程度与DR程度、视力、糖尿病病程均存在显著相关性.

An epidemiological surrey on diabetic macular edema in Huizhou city

Objective To investigate the prevalence of diabetic macular edema (DME) in Huizhou city and to explore the relationship of DME with the degrees of diabetic retinopathy (DR) and visual loss and the course of diabetes mellitus (DM). Methods Population samples in Huizhou were randomly selected to survey with questionnaires for DM screening. The patients then received vision tests, +90D front- position eyeground examination under a slit-lamp microscope, fundus photography, and fluorescence fundus an-giography (FFA) for DR and DME. Results Of 645 with DM, 262 developed DR and 92 occurred DME. The incidence of DME was 0.91% in Huizhou population, 1.43% in patients with DM, and 35.1% in the diabetic patients with DR. In DME 38.20% was mild, 31.46% was moderate, and 30.33% was severe. DME worsened with the increasing degree of DR (r= 0.945, P= 0.035). Visual loss was significantly correlated with the degree of DME (r= 0.972, P= 0.005). The grading of DME was markedly associated with the disease course of DM (r= 0.954, P= 0.008). Conclusions DME leads to severe vision impairment in diabetic patients. The patients with DME should be screened and treated earlier to reduce the incidence of DR-induced blindness. The degree of DME is markedly related with the stages of DR, visual loss, and course of diabetes.