在三级护理环境中糖尿病视网膜病变的患病率和进展:使用推查协议进行初步审查
Pir Salim Mahar1,2, Mohammad Daniyal Monis1, Muhammad Fahadullah Khan1
1Ophthalmology, Isra Postgraduate Institute of Ophthalmology, Karachi, PAK.
Cureus
|October 14, 2024
概括
糖尿病视网膜病变在巴基斯坦患者中进展迅速,需要比目前的年度指南建议更频繁的眼睛查. 建议对非增殖性糖尿病视网膜病变 (NPDR) 进行两年或三年一次的随访,以防止视力丧失.
科学领域:
- 眼科医生 眼科 眼科
- 糖尿病学 糖尿病学
- 公共卫生 公共卫生
背景情况:
- 糖尿病视网膜病变 (DR) 是糖尿病的一种严重并发症,影响视力.
- 早期发现和监测DR对于预防视力障碍至关重要.
- 目前的查方案可能不适合所有患者群体.
研究的目的:
- 为了评估患有正常 fundus 或非增殖性糖尿病视网膜病变 (NPDR) 的糖尿病患者.
- 在随访期间检查视网膜变化和进展.
- 建议修订DR查在第三级眼科护理机构的后续指南.
主要方法:
- 一项在糖尿病诊所进行了五年的前性纵向研究.
- 包括新诊断的II型糖尿病患者,其底部正常或NPDR的任何阶段.
- 排除患有增殖性糖尿病视网膜病变 (PDR),糖尿病黄斑 (DME) 或 fundus 非可见性的患者.
主要成果:
- 招募了251名患者:80名底部正常,171名患有NPDR (轻度,中度,严重).
- 观察到的高进展率:52.5%从轻度到中度NPDR (中位数3.5个月),37.1%从中度到重度NPDR (中位数4.5个月).
- 跨NPDR阶段的DME发展的显著发生率,在更严重的阶段出现的时间较短.
结论:
- 对于巴基斯坦人来说,需要紧急修订DR监测协议.
- 快速的NPDR进展和高的DME率需要更频繁的查.
- 年度查不足;对于正常/轻度NPDR,建议每两年进行一次,对于中度/重度NPDR,建议每季度进行一次.
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