Diabetic retinopathy in patients with newly diagnosed type 2 diabetes mellitus in Jordan: Prevalence and associated factors (约旦新诊断2型糖尿病患者的糖尿病视网膜病变：患病率与相关因素)

Background To determine the prevalence of diabetic retinopathy (DR) in patients with newly diagnosed type 2 diabetes mellitus (T2DM) in Jordan, as well as the factors associated with DR. Methods A cross-sectional study was conducted among 127 consecutive newly diagnosed (within the past 6 months) patients with T2DM attending one of two diabetic care centers. Complete ocular examinations were performed by an ophthalmologist and relevant data were collected. A fundus examination was performed using slit lamp indirect ophthalmoscopy after pupillary dilation with 1% tropicamide drops, with DR defined and classified according to the scale developed by the Global Diabetic Retinopathy Project Group. Results Of all the patients examined, 7.9% had DR. Of those with DR, 40% already had clinically significant macular edema necessitating laser photocoagulation or intravitreal injections. Multivariate analysis revealed that age and HbA1c were significantly associated with DR. The odds of DR increased by 11% for each 1 year increase in age (odds ratio [OR] 1.11; 95% confidence interval [CI] 1.02–1.20). For each 1% increase in HbA1c, the odds of DR increased by 43% (OR 1.43; 95% CI 1.09–1.88). Conclusions Fewer than one-tenth of newly diagnosed Jordanian patients with T2DM had DR, but more than one-third of these patients had significant maculopathy. Therefore, early screening is strongly recommended for all newly diagnosed T2DM patients. Increased age and HbA1c values are associated with increased odds of DR. A study with a larger sample size is needed to elucidate the risk factors for DR in newly diagnosed T2DM. 摘要 背景 测定约旦新诊断的2型糖尿病患者出现糖尿病视网膜病变的患病率，以及与糖尿病视网膜病变相关的因素。 方法 在就诊于两个糖尿病保健中心之一的连续的127名新诊断（在过去的6个月以内）的2型糖尿病患者中进行的横向研究。由一名眼科医师进行完整的眼部检查，并收集相关的数据。利用1%的托品酰胺滴剂散瞳后使用裂隙灯间接眼底镜检查法进行一次眼底检查，糖尿病视网膜病变的定义与分类依照全球糖尿病视网膜病变项目组制定的量表。 结果 在所有被检查的患者中，7.9%有糖尿病视网膜病变。在那些有糖尿病视网膜病变的患者中，40%在临床上已经出现显著的黄斑水肿，他们急需进行激光凝固治疗或者玻璃体内注射治疗。多元分析结果表明，年龄以及HbA1c均与糖尿病视网膜病变显著相关。年龄每增加1岁，出现糖尿病视网膜病变的几率增加11%（OR：1.11；95%Cl：1.02-1.20）。HbA1c每增加1%，出现糖尿病视网膜病变的几率增加43%（OR：1.43；95% CI：1.09-1.88）。 结论 约旦新诊断的2型糖尿病患者出现糖尿病视网膜病变的几率小于十分之一，但是出现糖尿病视网膜病变的患者中有显著黄斑病变的比例大于三分之一。因此，强烈推荐对所有新诊断的2型糖尿病患者进行早期筛查。年龄以及HbA1c值的增加均与糖尿病视网膜病变几率增加有关。需要进行一项更大样本量的研究来阐明新诊断的2型糖尿病患者出现糖尿病视网膜病变的危险因素。