糖尿病黄斑水肿患者视觉相关生活质量的调查

目的：评估伴有糖尿病黄斑水肿（DME）的2 型糖尿病患者的视觉相关生活质量（VRQoL）。方法：横 断面调查研究。将2017 年6 月至2019 年5 月从抚顺市眼病医院门诊招募的伴有DME的2 型糖尿病患 者（187 例）纳入研究。采用美国国立眼科研究院视功能问卷（NEI-VFQ-25）中文版量表来评估患者 的VRQoL。不同人口学特征、临床特征的DME患者间NEI-VFQ-25分数比较采用Wilcoxon秩和检验。 根据眼底照相将DME分为轻度、中度和重度。采用广义估计方程探讨DME严重程度与VRQoL的相 关性。结果：最终纳入DME患者159 例。伴视力损害患者的一般视力、近距离活动、远距离活动、 社交功能、依赖性、心理健康、角色困难、色觉、周边视觉和NEI-VFQ-25总分分数较无视力损害（小 数视力>0.3）患者低（均P<0.001）。双眼受累患者的一般健康、一般视力、近距离活动、远距离活动、 依赖性、心理健康、角色困难、驾驶、色觉、周边视野和NEI-VFQ-25 总分分数较单眼受累患者低 （均P<0.05）。随着DME严重程度的增加,一般健康（P趋势=0.013）、总体视力（P趋势<0.001）、近距离活 动（P趋势=0.001）、远距离活动（P趋势=0.002）、依赖性（P趋势=0.023）、心理健康（P趋势=0.001）、社会角色 （P趋势=0.022）、周边视野（P趋势=0.041）、NEI-VFQ-25总分（P趋势=0.001）的得分逐渐降低。NEI-VFQ-25 问卷中得分下降最多的是心理健康（β=-15.01,95%CI：-26.73～-3.30,P=0.012）和总体视力 （β=-13.66,95%CI：-19.86～-7.47,P<0.001）。结论：DME对VRQoL有明显的影响。随着DME严重 程度增加,VRQoL逐渐降低,尤其在总体视力和心理健康方面最为明显。

The Impact of Diabetic Macular Edema on Vision-Related Quality of Life in Type 2 Diabetes

Objective: To investigate the effect of diabetic macular edema (DME) on vision-related quality of life (VRQoL) in patients with type 2 diabetes. Methods: In this cross-sectional study, 187 patients with type 2 diabetes diagnosed with DME were included from June 2017 to May 2019. Questionnaires were completed to collect information about their sociodemographic and healthcare characteristics. VRQoL was assessed using the 25-Item National Eye Institute Visual Questionnaire (NEI-VFQ-25). NEI-VFQ-25 scores that were compared between groups using the Wilcoxon rank-sum test. The severity of DME in each eye was graded as mild, moderate, or severe. A generalized estimating equation model was used to assess the relationship between NEI-VFQ-25 scores and DME severity. Results: A total of 159 patients wererecruited for the study eventually. Compared with patients without visual impairment (decimal visual acuity >0.3), those with visual impairment showed statistically significant compromises in terms of general vision, near activities, distance activities, social functioning, dependency, mental health, role difficulties, color vision, peripheral vision, and NEI-VFQ-25 composite scores (P<0.001). Compared with unilateral DME, bilateral DME was associated with greater dependency and role difficulties, compromised near and distance activities, and poorer general health, general vision, color vision, peripheral vision, mental health, and NEIVFQ- 25 composite scores (P<0.05). Scores for NEI-VFQ-25 on general health (Ptrend=0.013), general vision (Ptrend<0.001), near activities (Ptrend=0.001), distance activities (Ptrend=0.002), mental health (Ptrend=0.001), role difficulties (Ptrend=0.022), dependency (Ptrend=0.023), peripheral vision (Ptrend=0.041) and NEI-VFQ-25 composite (Ptrend=0.001) decreased gradually as DME severity increased. β coefficients were the largest for mental health (β=-15.01, 95%CI: -26.73- -3.30, P=0.012) and general vision (β=-13.66, 95%CI: -19.86- -7.47, P<0.001). Conclusions: DME severity significantly affects patients' VRQoL, particularly their general vision and mental health. NEI-VFQ-25 should be widely used to assess overall health in patients.