| 【Purpose】Using Eye Grader: Eye Telemedicine Integrated System to analyze the prevalence diabetic retinopathy in Patients with Type 2Diabetes Mellitus with Course of More than 10 Years(Including10 Years)who were initially screened for DR,it provides a reference for the prevention and treatment of DR.【Objective】Retrospective clinical study.3875 patients with type 2diabetes that were screened for diabetic retinopathy for the first time in the Department of Ophthalmology of Hunan Provincial People’s Hospital from August 2016 to July 2020 were enrolled in the study.Collect the general situation of patients,diabetes related questionnaire : including name,gender,age,duration of diabetes,blood glucose control and medication,whether suffering from hypertension,etc.Then objective eye examination was performed,including naked eye vision,corrected visual acuity,intraocular pressure measurement and exclusion of glaucoma history.After pupil dilation with compound topiramide eye drops,fundus color photography was performed.Photography requires clear images without obvious exposure and reflection.The questionnaire results and photos were uploaded to Eye Grader: Eye Telemedicine Integrated System.The fundus photographs were automatically analyzed by computer-aided diagnosis technology,and then the screening report was generated by ophthalmologists in Hunan Provincial People ’ s Hospital.The reference standard was DR staging in the Clinical Guidelines for Diabetic Retinopathy(PPP-updated 2016)issued by AAO(American Academy of Ophthalmology)in February 2016.【Results】1.In the collected case data,1089 cases of type 2 diabetes patients with more than 10 years of course were collected,excluding 27 cases of corneal lesions,cataracts,vitreous opacity and other lesions lead to unclear binocular fundus,or fundus photographs are not clear cases,1062 cases of type 2diabetes patients with more than 10 years of course were collected.There were 521 males and 541 females.The oldest was96 years old,the smallest was 33 years old,and the average age was 63.2.Among 1062 patients with type 2 diabetes mellitus who had a course of more than 10 years,394 patients had DR,and the prevalence rate was 37.1%.Nonproliferative diabetic retinopathy(NPDR)323 cases,the prevalence rate was 30.4 %,proliferative diabetic retinopathy(PDR)71 cases,the prevalence rate was 6.7 %.3.There were 213 DR patients in 606 patients with type 2diabetes in the course of 10–15 years,and the prevalence rate was 35.1%.Among 456 patients with type 2 diabetes mellitus over15 years,there were 181 patients with DR,and the prevalence of DR was 39.7%.The prevalence of DR between groups was statistically significant(P<0.05).4.The number of first screening in the group under 50 years old was 49,and the proportion of screening was 4.6%.In the50-59 age group,184 people were screened for the first time,and the proportion of screening population was 17.3%.In the60–69-year-old group,the first screening number was 396,and the proportion of screening number was 37.3%.In the ≥70-year-old group,433 persons were screened for the first time,accounting for 40.8%.5.There were 129 patients with DR in 234 patients under 60 years old,the prevalence of DR was 55.1%,164 patients with DR in396 patients aged 60–69 years old,the prevalence of DR was44.4%,101 patients with DR in 432 patients aged 70 or above,the prevalence of DR was 23.3%.6.Among the 652 patients with type 2 diabetes mellitus and hypertension,252 patients had DR,and the prevalence of DR was38.6%.Among 410 patients without hypertension,142 had DR,and the prevalence of DR was 34.6%.The prevalence of DR between groups was statistically significant(P<0.05).According to the severity of DR,652 patients with type 2 diabetes mellitus complicated with hypertension,201 patients with NPDR,the prevalence rate was 30.8%.There were 410 patients with type 2diabetes without hypertension,122 patients with NPDR,the prevalence rate was 29.8%.The prevalence of NPDR between groups was statistically significant(P< 0.05).There were 652 patients with type 2 diabetes complicated with hypertension and51 patients with PDR,with the prevalence rate of 7.8%.There were 410 patients with type 2 diabetes without hypertension and20 patients with PDR,with a prevalence of 4.8%.The prevalence of PDR between groups was statistically significant(P<0.05).【Conclusion】1.The longer the course of disease in patients with type 2diabetes more than 10 years,the higher the prevalence of DR,the two are positively correlated.2.The number of type 2 diabetic patients over aged 60 was higher who were first screened for fundus examination in patients with type 2 diabetes over 10 years.3.For the first time,fundus screening was performed in patients with type 2 diabetes over 10 years.The prevalence of DR was highest in people under 60 years old,followed by 60-69 years old group.4.Patients with type 2 diabetes mellitus with hypertension more than 10 years of course are more likely to have DR. |
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