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Analiza występowania powikłań ocznych zagrażających widzeniu i ich czynników ryzyka w populacji mieszkańców Rzeszowa chorujących na cukrzycę typu 2.
The Analysis of Vision-threatening Ocular Complications and Their Risk Factors in the Population of Rzeszów Citizens with Type 2 Diabetes Mellitus
Anna Jędruch-Lampińska 1 , Magdalena Ulińska 2
1 Oddział Okulistyki Szpitala Miejskiego w Rzeszowie
2 Katedra i Klinika Okulistyki II Wydziału Lekarskiego Warszawskiego Uniwersytetu Medycznego
Kierownik Kliniki: prof. dr hab. n. med. Jacek P. Szaflik
Summary: Introduction: Diabetes has been considered as an epidemic of the 21st century, and diabetic retinopathy is one of the most common microvascular complications, which might lead to the loss of vision. According to global estimates, in 2010 there were 90 million people with a diabetic retinopathy, of whom 28 million were in advanced stages. It shall be stressed that the morbidity indices of diabetic retinopathy have been changing over the last decades. Moreover, in studies performed after 2000, the prevalence of visual impairment due to diabetic retinopathy is lower. However, the number of people with diabetic retinopathy has been steadily increasing owing to the “epidemic of diabetes”.
Aim: The aim of this study is to determine the prevalence of diabetic retinopathy, including vision-threatening diabetic retinopathy (i.e. proliferative diabetic retinopathy and diabetic macular edema) among type 2 diabetic patients from Rzeszow and to find risk factors of diabetic retinopathy in the studied population of type 2 diabetic patients.
Materials and Methods: We analyzed the data obtained from type 2 diabetic patients examined from June 2013 to December 2013 on the Ophthalmological Ward, Municipal Hospital in Rzeszow. Costs of screening tests for diabetic retinopathy in 223 patients (121 female, 102 male) were covered by the City Council in Rzeszow. The following data were recorded during visits: questionnaire-based medical history, height, body weight, blood pressure. In addition, all patients underwent ophthalmological examination, which included distance visual acuity assessment (with and without correction), intraocular pressure using applanation tonometry, anterior segment evaluation, as well as fundus evaluation following pupil dilation. Photographic documentation was made. In selected cases we performed additional exams: optical coherence tomography, fluorescein angiography or ultrasound.
Results and Conclusions:
1. The prevalence of diabetic retinopathy in the studied population of type 2 diabetic patients was 20.63%, taking into account all stages of retinopathy. Proliferative diabetic retinopathy was present in 0.45% of patients. Diabetic macular edema was found in 5.38% of patients.
2. The following independent clinical risk factors of diabetic retinopathy were found: duration of type 2 diabetes, glycated haemoglobin level (HbA1c), insulin treatment, and age over 60 years at diagnosis of diabetes.
Słowa kluczowe: cukrzyca, retinopatia cukrzycowa, retinopatia cukrzycowa zagrażająca widzeniu, retinopatia cukrzycowa proliferacyjna, cukrzycowy obrzęk plamki.
Keywords: diabetes, diabetic retinopathy, vision-threatening diabetic retinopathy, sight-threatening diabetic retinopathy, proliferative diabetic retinopathy, diabetic macular edema.