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Lin W, Li D, Wen L, Wang Y, Lin Z, Wang F, Liang Y. Prevalence and Risk Factors of Fundus Pathology in Patients with Type 2 Diabetes in a Northeastern Chinese Cohort. Ophthalmic Epidemiol 2024; 31:356-363. [PMID: 37727019 DOI: 10.1080/09286586.2023.2260855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 09/15/2023] [Indexed: 09/21/2023]
Abstract
PURPOSE To assess the prevalence of and risk factors for fundus pathology in patients with type 2 diabetes mellitus (T2DM) in a cohort from northeastern China. METHODS Patients were included from the Fushun Diabetic Retinopathy Cohort Study. Patients aged ≥ 30 years with T2DM were recruited between July 2012 and May 2013. Fundus pathology included retinal vascular occlusion (RVO), age-related macular degeneration (AMD), macular pathology, pathologic myopia (PM) and glaucomatous optic atrophy (GOA). RESULTS A Total of 1998 patients with gradable fundus photographs were included in this study, of whom 388 (19.42%) had fundus pathology regardless of whether they had diabetic retinopathy (DR). There were 187 (9.36%) patients with AMD, 97 (4.85%) with GOA, 67 (3.35%) with macular pathology, 35 (1.75%) with PM and 23 (1.15%) with RVO. Advanced age was significantly associated with AMD (odds ratio (OR), 95% confidence interval (CI): 1.03, 1.01-1.05), macular pathology (OR, 95% CI: 1.06, 1.03-1.09) and GOA (OR, 95% CI: 1.06, 1.04-1.09). A wider central retinal arteriolar equivalent was protective against PM (OR, 95% CI: 0.78, 0.66-0.92). Wider central retinal venular equivalent was a protective factor for PM (OR, 95% CI: 0.75, 0.68-0.82) and GOA (OR, 95% CI: 0.93, 0.87-0.99). CONCLUSIONS One-fifth of these patients in northeast China with T2DM had fundus pathology regardless of whether they had DR, indicating the importance of early screening and long-term follow-up.
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Affiliation(s)
- Wei Lin
- National Clinical Research Center for Ocular Diseases, Wenzhou, China
- Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Dong Li
- Fushun Eye Hospital, Fushun, Liaoning, China
| | - Liang Wen
- Fushun Eye Hospital, Fushun, Liaoning, China
| | - Yu Wang
- Fushun Eye Hospital, Fushun, Liaoning, China
| | - Zhong Lin
- National Clinical Research Center for Ocular Diseases, Wenzhou, China
- Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Fenghua Wang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Ophthalmology & Visual Science Key Lab, Beijing, China
| | - Yuanbo Liang
- National Clinical Research Center for Ocular Diseases, Wenzhou, China
- Eye Hospital, Wenzhou Medical University, Wenzhou, China
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Lin Z, Li D, Lin W, Wen L, Wang Y, Lin Z. THE IMPACT OF BILATERAL VISION STATUS ON VISION-RELATED QUALITY OF LIFE IN PEOPLE WITH DIABETES MELLITUS. Retina 2024; 44:1021-1025. [PMID: 38194676 DOI: 10.1097/iae.0000000000004047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2024]
Abstract
PURPOSE To assess the impact of bilateral vision status on vision-related quality of life (VR-QOL) in patients with Type 2 diabetes in a Chinese cohort. METHODS Patients with presenting visual acuity (PVA) and VR-QOL data from the Fushun Diabetic Retinopathy Cohort Study were included. Vision-related quality of life was assessed using the National Eye Institute Visual Function Questionnaire-25. Monocular PVA (Snellen) was categorized into three levels for both the better-seeing eye and worse-seeing eye: 1) high PVA (H, > 6/18); 2) moderate PVA (M, 6/18-6/60); and 3) low PVA (L, < 6/60). Based on the monocular PVAs, six categories of bilateral vision status were defined (H-H, H-M, H-L, M-M, M-L, and L-L). The parameters of VR-QOL were analyzed between the groups. RESULTS A total of 1,717 patients were enrolled. For better-seeing eyes in the same PVA level, the Visual Function Questionnaire-25 composite score decreased significantly with declining PVA in the worse-seeing eye (H-M vs. H-L: 80.5 ± 17.9 vs. 73.6 ± 22.5, P = 0.01; M-M vs. M-L: 78.7 ± 19.6 vs. 69.1 ± 26.4, P = 0.01). Conversely, for worse-seeing eyes in the same PVA level, there was no significant difference in the Visual Function Questionnaire-25 composite score as PVA changed in the better-seeing eye (H-M vs. M-M, 80.5 ± 17.9 vs. 78.7 ± 19.6, P = 0.30; H-L vs. M-L: 73.6 ± 22.5 vs. 69.1 ± 26.4, P = 0.25). CONCLUSION The PVA of the worse-seeing eye in bilateral vision has a greater impact on VR-QOL in diabetic patients. Priority treatment may be considered for the worse-seeing eye for diabetic patients with different bilateral vision statuses, to better improve VR-QOL.
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Affiliation(s)
- Zushun Lin
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China ; and
| | - Dong Li
- Fushun Eye Hospital, Fushun, Liaoning, China
| | - Wei Lin
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China ; and
| | - Liang Wen
- Fushun Eye Hospital, Fushun, Liaoning, China
| | - Yu Wang
- Fushun Eye Hospital, Fushun, Liaoning, China
| | - Zhong Lin
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China ; and
- Fushun Eye Hospital, Fushun, Liaoning, China
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Zang B, Rong S, Wang Y, Feng K, Ding X, Wen L, Zang D, Li D, Liang Y, Wang F, Zhai G. ASSOCIATION OF DIABETIC MACULAR EDEMA WITH QUALITY OF LIFE IN PATIENTS WITH TYPE 2 DIABETES: The Fushun Diabetic Retinopathy Cohort Study. Retina 2024; 44:537-544. [PMID: 37972959 DOI: 10.1097/iae.0000000000003992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 10/21/2023] [Indexed: 11/19/2023]
Abstract
PURPOSE To report the vision-related quality of life in patients with diabetic macular edema (DME) in a population-based study. METHODS In this cross-sectional study, we analyzed 1,659 subjects with type 2 diabetes. Questionnaires were administered to assess the patient's vision-related quality of life. Diabetic macular edema severity was graded according to the established protocols. A subject's DME score ranged from 1 (no DME in either eye) to 7 (severe bilateral DME) using predefined criteria. RESULTS Composite 25-item National Eye Institute Visual Function Questionnaire (NEI-VFQ-25) scores for participants with DME were 88.9 (interquartile range [IQR]: 76.2-94.9) compared with 92.0 (IQR: 82.7-96.0) for those without DME ( P < 0.001). Locally weighted scatterplot smoothing plots depicted a consistent decline in composite NEI-VFQ-25 scores corresponding to the escalation of bilateral DME severity: starting from 88.59 for no DME in either eye, progressing through 86.65, 85.83, 85.31, 84.91, 83.85, and culminating at 82.71 for bilateral severe DME. Notably, the locally weighted scatterplot smoothing plots highlighted significant NEI-VFQ-25 composite score reduction at unilateral mild DME (slope m = -1.94). CONCLUSION Significant changes in vision-related quality of life manifest in the early stage of DME. Therefore, early identification and intervention for these patients are crucial clinical objectives.
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Affiliation(s)
- Bo Zang
- Department of Ophthalmology, Fushun Eye Hospital, Fushun, Liaoning, China
| | - Shisong Rong
- Ophthalmology, Mass Eye and Ear, Mass General Brigham, Harvard Medical School, Boston, Massachusetts
| | - Yu Wang
- Department of Ophthalmology, Fushun Eye Hospital, Fushun, Liaoning, China
| | - Kemi Feng
- The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China; and
| | - Xiaoxia Ding
- Department of Ophthalmology, Fushun Eye Hospital, Fushun, Liaoning, China
| | - Liang Wen
- Department of Ophthalmology, Fushun Eye Hospital, Fushun, Liaoning, China
| | - Dongxiao Zang
- Department of Ophthalmology, Fushun Eye Hospital, Fushun, Liaoning, China
| | - Dong Li
- Department of Ophthalmology, Fushun Eye Hospital, Fushun, Liaoning, China
| | - Yuanbo Liang
- The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China; and
| | - Fenghua Wang
- Department of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Science Key Laboratory, Beijing, China
| | - Gang Zhai
- Department of Ophthalmology, Fushun Eye Hospital, Fushun, Liaoning, China
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Lin W, Li D, Wen L, Moonasar N, Wang Y, Lin Z. Aspirin intake is not associated with diabetic retinopathy and diabetic macular edema: A report from the Fushun diabetic retinopathy cohort study. Indian J Ophthalmol 2024; 72:S298-S302. [PMID: 38271427 DOI: 10.4103/ijo.ijo_2932_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 12/17/2023] [Indexed: 01/27/2024] Open
Abstract
PURPOSE We aimed to study the effects of aspirin intake for diabetic retinopathy (DR) and diabetic macular edema (DME) in a cohort from northeastern China. METHODS Participants in the Fushun Diabetic Retinopathy Cohort Study were enrolled between July 2012 and May 2013. Fundus photographs of six fields were graded according to the modified Airlie House Classification system. The prevalence, incidence, progression, and regression of DR, as well as the prevalence/incidence of DME, were evaluated at baseline and during follow-up examinations after at least 1 year. RESULTS In total, 1370 patients were enrolled in the study, and 270 (19.7%) were taking aspirin. The prevalence of any DR in participants with and without aspirin intake was 47.4% and 44.9%, respectively (P = 0.46). The incidence of any DR in patients with and without aspirin intake was 9.2% and 8.3%, respectively (P = 0.74). In univariate regression, there was no association between aspirin intake and the prevalence of any DR and DME (odds ratios (OR), 95% confidence intervals (CI): 0.93, 0.68-1.27 and 1.22, 0.79-1.88, respectively). Aspirin intake was not significantly associated with the prevalence and incidence of DME (OR, 95% CI: 1.22, 0.79-1.88 and 1.79, 0.62-5.17, respectively). Furthermore, aspirin intake was not significantly associated with DR progression or regression (OR, 95% CI: 1.04, 0.66-1.66 and 0.75, 0.52-1.09, respectively). CONCLUSION Aspirin intake was not associated with the prevalence and incidence of any DR or DME in a northeastern Chinese population. Neither progression nor regression of DR revealed a significant association with aspirin intake.
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Affiliation(s)
- Wei Lin
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Dong Li
- Fushun Eye Hospital, Liaoning, China
| | - Liang Wen
- Fushun Eye Hospital, Liaoning, China
| | | | - Yu Wang
- Fushun Eye Hospital, Liaoning, China
| | - Zhong Lin
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China
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Jiang JH, Wu RH, Ren MX, Lin K, Lin W, Hu XT, Chen F, Zhao ZQ, Ge LN, Lin Z. Surgical strategy and outcome in patients with bilateral proliferative diabetic retinopathy. Int Ophthalmol 2023; 43:4921-4931. [PMID: 37837486 DOI: 10.1007/s10792-023-02895-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 09/27/2023] [Indexed: 10/16/2023]
Abstract
OBJECTIVES To investigate the current surgery strategies for bilateral proliferative diabetic retinopathy (PDR), as well as the surgical outcomes of patients with bilateral PDR who underwent pars plana vitrectomy (PPV). MATERIALS Patients undergoing bilateral vitrectomy for PDR from January 2019 to December 2020 at The Eye Hospital of Wenzhou Medical University were enrolled. Clinical data were collected from the electronic medical records. Factors associated with the time interval between the surgeries on two eyes and postoperative visual outcomes were analyzed. RESULTS In total, 152 patients with bilateral PDR who underwent bilateral PPV were included in this analysis. Mean age was 53.7 ± 11.4 years. Compared with second-surgery eyes, 60.5% of first-surgery eyes had worse preoperative best-corrected visual acuity (BCVA). The overall PPV time (median, quartile range) between first and second surgeries eye was 1.40 (0.70, 3.15) months. Multivariate analysis showed that the preoperative BCVA of the second-surgery eye had a significant effect on the inter-surgery time interval (P = 0.048). First-surgery eyes had greater vision improvement than second-surgery eyes (Difference of the logarithm of the minimum angle of resolution [LogMAR] BCVA: - 1.00 [- 1.48, - 0.12] versus 0.00 [- 1.30, 0.00], respectively, P < 0.001), especially when eyes with poorer BCVA underwent PPV first (- 1.15 [- 1.87, - 0.54] versus 0.00 [- 0.70, 0.00], respectively, P < 0.001). CONCLUSIONS Visual acuity is a significant factor that influences surgical strategies, including both surgery order and interval, for patients with bilateral PDR. The eyes operated upon first show more vision improvement due to prompt surgery.
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Affiliation(s)
- Jun Hong Jiang
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, No. 270 West College Road, Wenzhou, 325027, Zhejiang, China
| | - Rong Han Wu
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, No. 270 West College Road, Wenzhou, 325027, Zhejiang, China
| | - Ming Xue Ren
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, No. 270 West College Road, Wenzhou, 325027, Zhejiang, China
| | - Ke Lin
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, No. 270 West College Road, Wenzhou, 325027, Zhejiang, China
| | - Wei Lin
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, No. 270 West College Road, Wenzhou, 325027, Zhejiang, China
| | - Xu Ting Hu
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, No. 270 West College Road, Wenzhou, 325027, Zhejiang, China
| | - Feng Chen
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, No. 270 West College Road, Wenzhou, 325027, Zhejiang, China
| | - Zhen Quan Zhao
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, No. 270 West College Road, Wenzhou, 325027, Zhejiang, China
| | - Li Na Ge
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, No. 270 West College Road, Wenzhou, 325027, Zhejiang, China
| | - Zhong Lin
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, No. 270 West College Road, Wenzhou, 325027, Zhejiang, China.
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Zang B, Rong S, Li D, Ding X, Zang D, Wang F, Liang Y, Zhai G, Feng K, Zhou Z, Wang Y. Undiagnosed diabetic retinopathy in Northeast China: prevalence and determinants. Front Endocrinol (Lausanne) 2023; 14:1263508. [PMID: 38093961 PMCID: PMC10716530 DOI: 10.3389/fendo.2023.1263508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 11/13/2023] [Indexed: 12/18/2023] Open
Abstract
Objective To report the prevalence and contributing factors of undiagnosed diabetic retinopathy (DR) in a population from Northeastern China. Subjects/Methods A total of 800 subjects from the Fushun Diabetic Retinopathy Cohort Study were enrolled. A questionnaire assessing incentives and barriers to diagnosis of DR was administered. Logistic regression was used to identify clinical and sociodemographic factors associated with undiagnosed DR. In a prespecified subgroup analysis, we divided patients into vision-threatening diabetic retinopathy (VTDR) and non-VTDR (NVTDR) subgroups. Results Among 800 participants with DR, 712 (89.0%) were undiagnosed. Among 601 with NVTDR, 566 (94.2%) were undiagnosed. Among 199 with VTDR, 146 (73.4%) were undiagnosed. The risk factors affecting the timely diagnosis of NVTDR and VTDR exhibit significant disparities. In multivariate models, factors associated with undiagnosed VTDR were age over 60 years (OR = 2.966; 95% CI = 1.205-7.299; P = 0.018), duration of diabetes over 10 years (OR = 0.299; 95% CI = 0.118-0753; P = 0.010), visual impairment or blindness (OR = 0.310; 95% CI = 0.117-0.820; P = 0.018), receiving a reminder to schedule an eye examination (OR = 0.380; 95% CI = 0.163-0.883; P = 0.025), and the belief that "people with diabetes are unlikely to develop an eye disease" (OR = 4.691; 95% CI = 1.116-19.724; P = 0.035). However, none of the factors were associated with undiagnosed NVTDR (all P ≥ 0.145). Conclusion Our research has uncovered a disconcerting trend of underdiagnosis in cases of DR within our population. Addressing determinants of undiagnosed DR may facilitate early detection.
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Affiliation(s)
- Bo Zang
- Department of Ophthalmology, Fushun Eye Hospital, Fushun, Liaoning, China
| | - Shisong Rong
- Mass Eye and Ear, Mass General Brigham, Harvard Medical School, Boston, MA, United States
| | - Dong Li
- Department of Ophthalmology, Fushun Eye Hospital, Fushun, Liaoning, China
| | - Xiaoxia Ding
- Department of Ophthalmology, Fushun Eye Hospital, Fushun, Liaoning, China
| | - Dongxiao Zang
- Department of Ophthalmology, Fushun Eye Hospital, Fushun, Liaoning, China
| | - Fenghua Wang
- Department of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Science Key Laboratory, Beijing, China
| | - Yuanbo Liang
- Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Gang Zhai
- Department of Ophthalmology, Fushun Eye Hospital, Fushun, Liaoning, China
| | - Kemi Feng
- Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Zixi Zhou
- Department of Ophthalmology, Fushun Eye Hospital, Fushun, Liaoning, China
| | - Yu Wang
- Department of Ophthalmology, Fushun Eye Hospital, Fushun, Liaoning, China
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Lin Z, Li D, Wen L, Wang Y, Wang FH, Liang YB. ASSOCIATION OF OCULAR PERFUSION PRESSURE AND CEREBROSPINAL FLUID PRESSURE WITH CHANGES IN DIABETIC RETINOPATHY. Retina 2023; 43:1107-1113. [PMID: 36977320 DOI: 10.1097/iae.0000000000003792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/30/2023]
Abstract
PURPOSE To investigate the association between mean ocular perfusion pressure (MOPP), estimated cerebrospinal fluid pressure (CSFP), and changes in diabetic retinopathy (DR) in a Northeastern Chinese population with Type 2 diabetes. METHODS A total of 1,322 subjects from the Fushun Diabetic Retinopathy Cohort Study were enrolled. Systolic blood pressure (SBP), diastolic blood pressure (DBP), and intraocular pressure (IOP) were recorded. MOPP was calculated by the following formula: MOPP = 2/3 [DBP + 1/3 (SBP - DBP)] - IOP, and CSFP was estimated according to the following formula: CSFP = 0.44 × body mass index + 0.16 × DBP - 0.18 × age - 1.91. New development, progression, and regression of DR were graded based on fundus photographs at baseline and during follow-up examinations with a mean interval of 21.2 months using the modified Early Treatment Diabetic Retinopathy Study criteria. RESULTS Increasing MOPP was associated with the incidence of DR in the multivariate model (per 1-mmHg increase: relative risk, 1.06; 95% confidence interval, 1.02-1.10; P = 0.007) and showed a borderline negative association with DR regression (per 1-mmHg increase: relative risk, 0.98; 95% confidence interval, 0.97-1.00; P = 0.053). However, MOPP was not associated with progression of DR. Cerebrospinal fluid pressure was not associated with new development, progression, or regression of DR. CONCLUSION The MOPP, but not the CSFP, was found to influence the development, but not the progression of DR in this Northeastern Chinese cohort.
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Affiliation(s)
- Zhong Lin
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Dong Li
- Fushun Eye Hospital, Fushun, Liaoning, China; and
| | - Liang Wen
- Fushun Eye Hospital, Fushun, Liaoning, China; and
| | - Yu Wang
- Fushun Eye Hospital, Fushun, Liaoning, China; and
| | - Feng Hua Wang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Science Key Lab, Beijing, China
| | - Yuan Bo Liang
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China
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Lin Z, Wen L, Li D, Moonasar N, Zhai G, Wang Y, Wang FH, Liang YB. Refractive Error in a Chinese Population with Type 2 Diabetes: A Report from the Fushun Diabetic Retinopathy Cohort Study. Ophthalmic Epidemiol 2023; 30:38-45. [PMID: 35188061 DOI: 10.1080/09286586.2022.2031228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE To describe the prevalence and risk factors for refractive errors in a northeastern Chinese population with type 2 diabetes. METHODS Subjects (age ≥30 years) from a community-based study, the Fushun Diabetic Retinopathy Cohort Study, were enrolled. All subjects underwent comprehensive ocular examinations, including autorefraction. Myopia, high myopia, and hyperopia were defined as a spherical equivalent (SE) of the right eye <-0.5 diopter (D), <-5.0D, and >0.5D, respectively. Astigmatism was defined as cylinder <-0.5D in a minus cylinder prescription. Anisometropia was defined as a difference of SE >1.0D between two eyes. RESULTS A total of 1929 participants (790 males, 41.0%) were enrolled. The age and gender standardized prevalence of myopia, high myopia, hyperopia, astigmatism, and anisometropia were 43.1% (95% confidence interval [CI]: 40.9%-45.3%), 8.5% (95% CI: 7.3%-9.8%), 21.5% (95% CI: 19.7%-23.4%), 61.0% (95% CI: 58.9%-63.2%), and 17.2% (95% CI: 15.5%-18.9%), respectively. Advancing age was associated with a higher frequency of hyperopia, astigmatism, and anisometropia, as opposed to a lower frequency of myopia. Female (adjusted odds ratio [aOR], 1.27; 95% CI, 1.02-1.57) participants, higher intraocular pressure (aOR, 1.03; 95% CI, 1.00-1.07), and lenticular opacity (aOR, 1.53; 95% CI, 1.20-1.94) were also found to be associated with myopia. Long duration of diabetes (>15 years) was found to be a significant factor for astigmatism (aOR, 1.62; 95% CI, 1.15-2.27) and anisometropia (aOR, 1.87; 95% CI, 1.29-2.71). CONCLUSION Nearly two-thirds of participants with type 2 diabetes had a refractive error. Age is a common factor with different types of refractive errors.
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Affiliation(s)
- Zhong Lin
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China.,National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, China
| | - Liang Wen
- Fushun Eye Hospital, Fushun, Liaoning Province, China
| | - Dong Li
- Fushun Eye Hospital, Fushun, Liaoning Province, China
| | | | - Gang Zhai
- Fushun Eye Hospital, Fushun, Liaoning Province, China
| | - Yu Wang
- Fushun Eye Hospital, Fushun, Liaoning Province, China
| | - Feng Hua Wang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Ophthalmology & Visual Science Key Lab, Beijing, China
| | - Yuan Bo Liang
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China.,National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, China
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Lin Z, Wen L, Wang Y, Li D, Zhai G, Moonasar N, Wang F, Liang Y. Incidence, progression and regression of diabetic retinopathy in a northeastern Chinese population. Br J Ophthalmol 2022; 107:bjophthalmol-2022-321384. [PMID: 35864776 DOI: 10.1136/bjo-2022-321384] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 06/27/2022] [Indexed: 11/04/2022]
Abstract
AIM To determine the incidence, progression and regression of diabetic retinopathy (DR), with corresponding risk factors, in a northeastern Chinese population of patients with type 2 diabetes. METHODS Among 2006 patients who completed baseline examinations in 2012-2013 and underwent re-examination after a mean interval of 21.2 months, 1392 patients with gradable fundus photographs for both baseline and follow-up examinations were included. Incidence was defined as new development of any DR among patients without DR at baseline. An increase of ≥2 scales (concatenating Early Treatment Diabetic Retinopathy Study levels of both eyes) in eyes with DR at baseline was defined as progression, while a reduction of ≥2 scales was defined as regression. RESULTS The age- and sex-standardised incidence, progression and regression were 5.8% (95% CI 4.7% to 6.9%), 26.8% (95% CI 24.8% to 28.8%) and 10.0% (95% CI 8.6% to 11.3%), respectively. In addition to poor blood glucose control, wider central retinal venular equivalent was associated with both incidence (relative risk (RR) 2.17, 95% CI 1.09 to 4.32, for ≥250 µm vs <210 µm) and progression (RR 2.00, 95% CI 1.02 to 3.96, for ≥250 µm vs <210 µm). Patients without insulin therapy (RR 0.64, 95% CI 0.43 to 0.97) and patients with wider central retinal arteriolar equivalent (RR 1.14, 95% CI 1.02 to 1.26, per 10 µm increase) were likely to exhibit DR regression. CONCLUSION We determined the incidence, progression and regression of DR among northeastern Chinese patients with type 2 diabetes. Retinal vessel diameters, in addition to blood glucose level, influence the natural evolution of DR.
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Affiliation(s)
- Zhong Lin
- The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
- National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, China
| | - Liang Wen
- Department of Ophthalmology, Fushun Eye Hospital, Fushun, Liaoning, China
| | - Yu Wang
- Department of Ophthalmology, Fushun Eye Hospital, Fushun, Liaoning, China
| | - Dong Li
- Department of Ophthalmology, Fushun Eye Hospital, Fushun, Liaoning, China
| | - Gang Zhai
- Department of Ophthalmology, Fushun Eye Hospital, Fushun, Liaoning, China
| | | | - Fenghua Wang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Yuanbo Liang
- The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
- National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, China
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Ding X, Rong S, Wang Y, Li D, Wen L, Zou B, Zang D, Feng K, Liang Y, Wang F, Zhai G. The Association of the Prevalence of Depression in Type 2 Diabetes Mellitus with Visual-Related Quality of Life and Social Support. Diabetes Metab Syndr Obes 2022; 15:535-544. [PMID: 35237054 PMCID: PMC8882658 DOI: 10.2147/dmso.s343926] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 01/22/2022] [Indexed: 11/23/2022] Open
Abstract
AIM To report the prevalence of depression and its association with vision-related quality of life and social support in a type 2 diabetes mellitus (T2DM) population. METHODS Patients were recruited from a community-based study, Fushun Diabetic Retinopathy Cohort Study (FS-DIRECT), conducted between July 2012 and May 2013 in China. Depression was assessed using the Centre for Epidemiological Studies Depression Scale (CES-D). Vision-related quality of life was evaluated using the Visual Function Questionnaire-25 (VFQ-25). Social support was captured with the Social Support Rating Scale (SSRS). Generalized linear models were used to estimate the individual and joint association of VFQ-25 composite score (VFQCS) and SSRS score (SSRSS) with depression. RESULTS A total of 1618 subjects (60.9% female) aged 61.69 ± 8.72 years in an urban district of Jiangjun Street, Fushun City, Liaoning province, Northeast China from July 2012 to May 2013 were recruited, of which, 23.36% (95% CI: 21.30-25.42%) were identified with depression. Every 14.1 increase in VFQ-25 composite score decreased the risk of depression by half (OR = 0.5; 95% CI: 0.4-0.6); with the elevation of 10.0 SSRS score the risk of depression decreased by 40% (OR = 0.6; 95% CI: 0.5-0.7). Patients with the VFQCS less than 91.3 and SSRSS less than 38.0 had 5.9 times more risk of depression (OR = 5.9; 95% CI: 3.6-9.7). Age (over 60 years) (OR = 0.6; 95% CI: 0.4-0.9) and medical history of cardiovascular disease (OR = 1.7; 95% CI: 1.1-2.5) were independently correlated with depression symptom. CONCLUSION The prevalence of depression is high among patients with T2DM in urban district in northeast China. Vision-related quality of life and social support scores are significantly associated with depression. Measures should be taken to screen depressive symptoms in patients with type 2 diabetes patients. These patients need to be intervened with appropriate and effective treatment as early as possible. Meanwhile, behavioral health specialists should guide the patient to get and use social support sources effectively.
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Affiliation(s)
- Xiaoxia Ding
- Department of Ophthalmology, Fushun Eye Hospital, Fushun, Liaoning, People’s Republic of China
| | - Shisong Rong
- Department of Ophthalmology, Harvard Medical School, Massachusetts Eye and Ear, Boston, MA, USA
| | - Yu Wang
- Department of Ophthalmology, Fushun Eye Hospital, Fushun, Liaoning, People’s Republic of China
| | - Dong Li
- Department of Ophthalmology, Fushun Eye Hospital, Fushun, Liaoning, People’s Republic of China
| | - Liang Wen
- Department of Ophthalmology, Fushun Eye Hospital, Fushun, Liaoning, People’s Republic of China
| | - Bo Zou
- Department of Ophthalmology, Fushun Eye Hospital, Fushun, Liaoning, People’s Republic of China
| | - Dongxiao Zang
- Department of Ophthalmology, Fushun Eye Hospital, Fushun, Liaoning, People’s Republic of China
| | - Kemi Feng
- Department of Ophthalmology, the Affiliated Eye Hospital, School of Optometry and Ophthalmology, Wenzhou Medical University, Wenzhou, Zhejiang, People’s Republic of China
| | - Yuanbo Liang
- Department of Ophthalmology, the Affiliated Eye Hospital, School of Optometry and Ophthalmology, Wenzhou Medical University, Wenzhou, Zhejiang, People’s Republic of China
| | - Fenghua Wang
- Department of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Science Key Laboratory, Beijing, People’s Republic of China
| | - Gang Zhai
- Department of Ophthalmology, Fushun Eye Hospital, Fushun, Liaoning, People’s Republic of China
- Correspondence: Gang Zhai, Fushun Eye Hospital, No. 1 Hupo Street, Xinfu District, Fushun, Liaoning, 113008, People’s Republic of China, Email
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Higher prevalence of diabetic retinopathy among female Chinese diabetic patients with metabolic syndrome. Jpn J Ophthalmol 2021; 66:102-109. [PMID: 34655347 DOI: 10.1007/s10384-021-00877-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 06/28/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE To investigate the association between metabolic syndrome (MetS) and diabetic retinopathy (DR), as well as the association between MetS and retinal vessel caliber, among Chinese patients with type 2 diabetes mellitus in north-eastern China. STUDY DESIGN Cross-sectional study. PATIENTS AND METHODS The patients were recruited from a community-based study, the Fushun Diabetic Retinopathy Cohort Study (FS-DIRECT). The presence of DR was determined using a modified version of the Early Treatment Diabetic Retinopathy Study (ETDRS) scale. The central retinal arteriolar equivalent (CRAE) and the central retinal venular equivalent (CRVE) were identified by use of Integrative Vessel Analysis software. The presence of MetS was defined according to the Joint Interim Statement proposed in 2009. RESULTS The prevalence of DR was significantly higher among female patients with MetS than among those without it (47.2% vs 30.9%, P = 0.002), and it increased as the number of MetS components increased (P = 0.003). Furthermore, the presence of MetS (odds ratio 2.43, 95% CI 1.39-4.26) as well as higher numbers of MetS components were significantly associated with DR in female patients, after adjustment for potential risk factors. Patients with MetS (multivariate β coefficient, 95% CI - 6.9, - 10.0, to - 3.8) or a higher number of Mets components tended to have significantly smaller CRAE. CONCLUSION In this study cohort, female patients with MetS had a higher prevalence of DR. Patients tended to have thinner central retinal arterioles as the number of MetS components increased.
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The Prevalence and Causes of Visual Impairment in Type 2 Diabetes Mellitus in Northeast China. J Ophthalmol 2020; 2020:5969816. [PMID: 33312726 PMCID: PMC7719542 DOI: 10.1155/2020/5969816] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Accepted: 04/01/2020] [Indexed: 11/26/2022] Open
Abstract
Purpose To evaluate the prevalence and causes of visual impairment in a group of community people with type 2 diabetes mellitus (T2DM) in Northeast China. Methods Population-based cross-sectional survey. Patients diagnosed with T2DM residing in 15 communities in Fushun, Northeast China, were enrolled between July 2012 and May 2013. All participants underwent an extensive and standardized eye examination (visual acuity testing, slit-lamp, and fundus examination). Low vision was defined as presenting VA of better-seeing eye <20/60 and ≥20/400, and blindness was defined as VA <20/400, according to the World Health Organization (WHO) definitions. The primary causes of blindness and low vision were assessed by senior ophthalmologists. Results Visual acuity measurements were available for 1998 (89.8%) of 2224 subjects in the study. The prevalence of bilateral blindness and low vision defined was 0.90% and 10.81%. Uncorrected refractive error was the first leading cause of low vision (75.0%) and blindness (38.9%). After correcting the refractive error, the first leading cause of low vision was cataract (44.4%), followed by diabetic retinopathy (29.6%) and myopic maculopathy (18.5%), while the first leading cause of blindness was proliferative DR (45.4%), followed by cataract (36.4%) and myopic maculopathy (18.2%). Conclusions This study suggested a high prevalence of low vision and blindness in this study cohort. Uncorrected refractive error and cataract remain the leading cause of visual impairment, but the major challenge is the early diagnosis and intervention of diabetic retinopathy to reduce diabetes-related blindness.
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Lin Z, Li D, Zhai G, Wang Y, Wen L, Ding XX, Wang FH, Dou Y, Xie C, Liang YB. High myopia is protective against diabetic retinopathy via thinning retinal vein: A report from Fushun Diabetic Retinopathy Cohort Study (FS-DIRECT). Diab Vasc Dis Res 2020; 17:1479164120940988. [PMID: 32686483 PMCID: PMC7510364 DOI: 10.1177/1479164120940988] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
PURPOSE To investigate the association between high myopia and diabetic retinopathy, and its possible mechanism, in a northeastern Chinese population with type 2 diabetic mellitus. METHODS Patients were included from Fushun Diabetic Retinopathy Cohort Study. High myopia was defined as spherical equivalent of autorefraction less than -5D. RESULTS A total of 1817 patients [688 (37.9%) diabetic retinopathy, 102 (5.6%) high myopia] were included. Compared to eyes without high myopia, the frequency of diabetic retinopathy and non-proliferative diabetic retinopathy was significantly less in eyes with high myopia (23.5% vs 38.7%, p = 0.002; 22.5% vs 35.3%, p = 0.005). Eyes with high myopia were less likely to have diabetic retinopathy (multivariate odds ratio, 95% confidence interval: 0.39, 0.22-0.68) or non-proliferative diabetic retinopathy (odds ratio, 95% confidence interval: 0.40, 0.23-0.70). High myopia was negatively associated with central retinal venular equivalent (multivariate β, 95% confidence interval: -37.1, -42.3 to -31.8, p < 0.001). Furthermore, central retinal venular equivalent (per 10 μm increase) had a significant association with diabetic retinopathy (odds ratio, 95% confidence interval: 1.24, 1.17-1.31) as well as non-proliferative diabetic retinopathy (odds ratio, 95% confidence interval: 1.24, 1.18-1.31). CONCLUSIONS High myopia was negatively associated with both diabetic retinopathy and non-proliferative diabetic retinopathy in this northeastern Chinese population. This protective effect may have been partially achieved via thinning retinal veins.
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Affiliation(s)
- Zhong Lin
- School of Ophthalmology & Optometry, Wenzhou Medical University, Eye Hospital of Wenzhou Medical University, Wenzhou, China
| | - Dong Li
- Fushun Eye Hospital, Liaoning, Province, China
| | - Gang Zhai
- Fushun Eye Hospital, Liaoning, Province, China
- Gang Zhai, Fushun Eye Hospital, No. 1 Hu Po Quan Street, Xin Fu District, Fushun, Liaoning 113006, China.
| | - Yu Wang
- Fushun Eye Hospital, Liaoning, Province, China
| | - Liang Wen
- Fushun Eye Hospital, Liaoning, Province, China
| | | | - Feng Hua Wang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Ophthalmology & Visual Science Key Lab, Beijing, China
| | - Yu Dou
- Fushun Eye Hospital, Liaoning, Province, China
| | - Cong Xie
- Fushun Eye Hospital, Liaoning, Province, China
| | - Yuan Bo Liang
- School of Ophthalmology & Optometry, Wenzhou Medical University, Eye Hospital of Wenzhou Medical University, Wenzhou, China
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