CAJ | 학술논문

目的：研究视网膜血管疾病在印度喜马偕尔邦丘陵地带(海拔500~4500m)的患病模式/分布。 　　方法：对西姆拉三级医院眼科自2008-08/2013-04期间的视网膜疾病患者进行回顾/前瞻性研究。选取5600位中的4323名患者作为研究对象。该数据均来自于医院记录,随后根据患者的年龄,性别分布情况和诊断结果进行分析。所有患者都进行了视力,屈光,裂隙灯和眼底检查。以眼底临床记录和眼底照相记录来确定诊断。应用眼底照像机( Kowa Fundus Camera VX-10)进行照相,必要时进行眼底荧光素血管造影。 　　结果：在4323例患者中,男性视网膜疾病患者有2563例(59.29%),多于女性1760例(40.71%)。在525例(12.14%)糖尿病视网膜病变患者中,轻度非增殖性糖尿病视网膜病变133例(3.08%),中度156例(3.60%),重度120例(2.78%),增殖性糖尿病视网膜病变116例(2.68%)。在393例(9.10%)高血压性视网膜病变患者中,I级高血压性视网膜病变患者130例(3.01%),II级111例(2.57%),III级131例(3.03%),IV级21例(0.49%)。在660例(15.27%)其他视网膜血管疾病中,视网膜分支静脉阻塞229例(5.30%),视网膜中央静脉阻塞55例(1.27%),半视网膜中央静脉阻塞8例(0.19%),视网膜中央动脉阻塞20例(0.46%),视网膜分支动脉阻塞4例(0.09%),眼部缺血综合征1例(0.02%),早产儿视网膜病变9例(0.21%),视网膜大动脉瘤5例(0.12%),近中心凹毛细血管扩张6例(0.14%),贫血性视网膜病变16例(0.37%),白血病视网膜病变10例(0.23%),视网膜前出血52例(1.20%),Coats病8例(0.19%),睫状视网膜动脉阻塞1例(0.02%)例,Eales病10例(0.23%),血管炎17例(0.39%)以及有临床意义的黄斑水肿209例(4.83%)。 　　结论：糖尿病视网膜病变是最常见的视网膜血管疾病。视网膜疾病已经成为印度一个主要公共卫生问题。此研究将有利于对喜马偕尔邦丘陵地带视网膜血管疾病的控制管理从而减少该眼病的发病率。目的：研究視網膜血管疾病在印度喜馬偕爾邦丘陵地帶(海拔500~4500m)的患病模式/分佈。 　　方法：對西姆拉三級醫院眼科自2008-08/2013-04期間的視網膜疾病患者進行迴顧/前瞻性研究。選取5600位中的4323名患者作為研究對象。該數據均來自于醫院記錄,隨後根據患者的年齡,性彆分佈情況和診斷結果進行分析。所有患者都進行瞭視力,屈光,裂隙燈和眼底檢查。以眼底臨床記錄和眼底照相記錄來確定診斷。應用眼底照像機( Kowa Fundus Camera VX-10)進行照相,必要時進行眼底熒光素血管造影。 　　結果：在4323例患者中,男性視網膜疾病患者有2563例(59.29%),多于女性1760例(40.71%)。在525例(12.14%)糖尿病視網膜病變患者中,輕度非增殖性糖尿病視網膜病變133例(3.08%),中度156例(3.60%),重度120例(2.78%),增殖性糖尿病視網膜病變116例(2.68%)。在393例(9.10%)高血壓性視網膜病變患者中,I級高血壓性視網膜病變患者130例(3.01%),II級111例(2.57%),III級131例(3.03%),IV級21例(0.49%)。在660例(15.27%)其他視網膜血管疾病中,視網膜分支靜脈阻塞229例(5.30%),視網膜中央靜脈阻塞55例(1.27%),半視網膜中央靜脈阻塞8例(0.19%),視網膜中央動脈阻塞20例(0.46%),視網膜分支動脈阻塞4例(0.09%),眼部缺血綜閤徵1例(0.02%),早產兒視網膜病變9例(0.21%),視網膜大動脈瘤5例(0.12%),近中心凹毛細血管擴張6例(0.14%),貧血性視網膜病變16例(0.37%),白血病視網膜病變10例(0.23%),視網膜前齣血52例(1.20%),Coats病8例(0.19%),睫狀視網膜動脈阻塞1例(0.02%)例,Eales病10例(0.23%),血管炎17例(0.39%)以及有臨床意義的黃斑水腫209例(4.83%)。 　　結論：糖尿病視網膜病變是最常見的視網膜血管疾病。視網膜疾病已經成為印度一箇主要公共衛生問題。此研究將有利于對喜馬偕爾邦丘陵地帶視網膜血管疾病的控製管理從而減少該眼病的髮病率。
목적：연구시망막혈관질병재인도희마해이방구릉지대(해발500~4500m)적환병모식/분포。 　　방법：대서모랍삼급의원안과자2008-08/2013-04기간적시망막질병환자진행회고/전첨성연구。선취5600위중적4323명환자작위연구대상。해수거균래자우의원기록,수후근거환자적년령,성별분포정황화진단결과진행분석。소유환자도진행료시력,굴광,렬극등화안저검사。이안저림상기록화안저조상기록래학정진단。응용안저조상궤( Kowa Fundus Camera VX-10)진행조상,필요시진행안저형광소혈관조영。 　　결과：재4323례환자중,남성시망막질병환자유2563례(59.29%),다우녀성1760례(40.71%)。재525례(12.14%)당뇨병시망막병변환자중,경도비증식성당뇨병시망막병변133례(3.08%),중도156례(3.60%),중도120례(2.78%),증식성당뇨병시망막병변116례(2.68%)。재393례(9.10%)고혈압성시망막병변환자중,I급고혈압성시망막병변환자130례(3.01%),II급111례(2.57%),III급131례(3.03%),IV급21례(0.49%)。재660례(15.27%)기타시망막혈관질병중,시망막분지정맥조새229례(5.30%),시망막중앙정맥조새55례(1.27%),반시망막중앙정맥조새8례(0.19%),시망막중앙동맥조새20례(0.46%),시망막분지동맥조새4례(0.09%),안부결혈종합정1례(0.02%),조산인시망막병변9례(0.21%),시망막대동맥류5례(0.12%),근중심요모세혈관확장6례(0.14%),빈혈성시망막병변16례(0.37%),백혈병시망막병변10례(0.23%),시망막전출혈52례(1.20%),Coats병8례(0.19%),첩상시망막동맥조새1례(0.02%)례,Eales병10례(0.23%),혈관염17례(0.39%)이급유림상의의적황반수종209례(4.83%)。 　　결론：당뇨병시망막병변시최상견적시망막혈관질병。시망막질병이경성위인도일개주요공공위생문제。차연구장유리우대희마해이방구릉지대시망막혈관질병적공제관리종이감소해안병적발병솔。
AlM: To study the pattern/distribution of retinal vascular diseases in the hilly terrain of Himachal Pradesh (altitude ranging from 500-4500m above sea level). METHODS: lt is a retro/prospective study of patients with retinal diseases attending the general ophthalmology clinic of a tertiary care facility at Shimla from August 2008 to April 2013. Out of 5600 subjects, 4323 were taken as a sample. The data were taken from the hospital records and thereafter analyzed to determine their age, sex distribution and diagnosis. All patients underwent visual acuity, refraction, slit lamp examination and fundus evaluation. The diagnosis was confirmed from fundus clinic records and evaluation of fundus photographic records retro/prospectively. The photographs were taken on the fundus camera (Kowa Fundus Camera VX-10) and fundus fluorescein angiography done where ever indicated. RESULTS:Out of the 4323 patients, there were more males 2563 ( 59. 29%) than females 1760 ( 40. 71%) with retinal diseases. Out of the 525 ( 12. 14%) diabetic retinopathy ( DR) subjects, mild non-proliferative diabetic retinopathy was present in 133 (3. 08%), moderate non-proliferative diabetic retinopathy in 156 (3. 60%), severe non-proliferative diabetic retinopathy in 120 (2. 78%) and proliferative diabetic retinopathy in 116 (2. 68%) subjects. Amongst the 393 (9. 10%) subjects of hypertensive retinopathy, hypertensive retinopathy-grade 1 ( was present in 130 ( 3. 01%) , hypertensive retinopathy - grade 2 in 111 (2. 57%), hypertensive retinopathy-grade 3 in 131 (3. 03%) and hypertensive retinopathy - grade 4 in 21 ( 0. 49%) subjects. Of all the 660 (15. 27%) subjects of other retinal vascular disorders, branch retinal vein occlusion ( BRVO) was present in 229 (5. 30%), central retinal vein occlusion (CRVO) in 55 (1. 27%), hemi central vein occlusion in 8 (0. 19%), central retinal artery occlusion ( CRAO) in 20 (0. 46%), branch retinal artery occlusion in 4 (0. 09%), ocular ischaemic syndrome in 1 (0. 02%), retinopathy of prematurity in 9 (0. 21%), retinal artery macroaneurysm in 5 (0. 12%), juxtafoveal telangiectasia in 6 (0. 14%), anaemic retinopathy in 16 (0. 37%), leukemic retinopathy in 10 (0. 23%), preretinal haemorrhage in 52 (1. 20%), Coats disease in 8 (0. 19%), cilioretinal artery occlusion in 1 (0. 02%), Eales disease in 10 (0. 23%), vasculitis in 17 (0. 39%) and clinically significant macular edema in 209 (4. 83%) subjects. CONCLUSlON: DR was the most common retinal vascular disorder. Retinal disorders appear to be a major public health problem in lndia. The present study shall help us in planning the management of such disorders in the hilly state of Himachal Pradesh to reduce the visual morbidity arising out of such disorders.