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糖尿病性视网膜病变患者的评估与治疗
Evaluation and Care of Patients with Diabetic Retinopathy


Lee M. Jampol ... 糖尿病 • 2020.04.23
相关阅读
• 糖尿病性视网膜病变 • 全视网膜光凝术在治疗增殖性糖尿病视网膜病变中的应用

几个世纪前,人们就已经知道糖尿病的血管并发症,包括被称为糖尿病性视网膜病变的视网膜损害。在过去10年间,视网膜成像等技术的进步和新疗法的研发极大改善了糖尿病性视网膜病变患者的评估、治疗和视力结局。尽管如此,在大多数发达国家,糖尿病性黄斑水肿和增值型糖尿病性视网膜病变仍然是导致中度和重度视力丧失的主要原因。本文综述了糖尿病性视网膜病变在全球范围内的影响,以及该病患者在评估和治疗方面的最新变化。

 

糖尿病和糖尿病性视网膜病变的全球概况


大多数患者在确诊为糖尿病后10~15年发生视网膜病变。随着糖尿病患病率的增加,越来越多的人面临视网膜病变的风险,需要更多的资源来识别和治疗糖尿病性视网膜病变。到2045年,全球预计将有6.29亿人患糖尿病1。发展中国家和发达国家的糖尿病患病率都在增加2。在中国,糖尿病患病率从1980年的不到1%上升至2013年的11.6%,糖尿病患者达到1.14亿1。2018年,美国成人中的糖尿病患病率估计为10.2%(2,680万例)3。2019年,糖尿病在全球范围内导致了420万人死亡,并产生了7,600亿美元的医疗支出1

考虑到疾病负担,对糖尿病性视网膜病变进行高效且准确的诊断、风险评估和治疗至关重要。在全球范围内,从1990—2010年,糖尿病性视网膜病变导致的视力损害增加了64%,致盲病例增加了27%4。截至2010年,糖尿病性视网膜病变导致的视力损害病例达到370万,致盲病例达到83.3万,并且糖尿病相关眼病是全球范围内导致中度至重度视力丧失和致盲的第五大病因4,5。幸运的是,我们最近在糖尿病相关眼病的识别、评估和治疗方面取得了进展,这些进展正在帮助一些国家减轻视力丧失的总体负担,特别是在对糖尿病性视网膜病变实施全国性筛查计划的国家。





作者信息

Lee M. Jampol, M.D., Adam R. Glassman, M.S., and Jennifer Sun, M.D., M.P.H.
From the Feinberg School of Medicine, Northwestern University, Chicago (L.M.J.); the Jaeb Center for Health Research, Tampa, FL (A.R.G.); and the Department of Ophthalmology, Harvard Medical School, and Beetham Eye Institute at Joslin Diabetes Center — both in Boston (J.S.). Address reprint requests to Mr. Glassman at the Jaeb Center for Health Research, 15310 Amberly Dr., Suite 350, Tampa, FL 33647, or at drcrstat2@jaeb.org.

 

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