ﺩﻫﻘﺎﻥ ﻣﺤﻤﺪﺣﺴﻴﻦ ﺩﮐﺘﺮ- ﺩﻳﺎﺑﺘﻲ ﺭﺗﻴﻨﻮﭘﺎﺗﻲ ﺧﻄﺮ ﻋﻮﺍﻣﻞ ﻳﺰﺩ ﺷﻬﺮﺳﺘﺎﻥ ﺩﺭ ٣٧٥ Prevalence and Risk Factors of Diabetic Retinopathy in Yazd Province Dehghan MH, MD; Katibeh M, MD*; Ahmadieh H, MD; Ramezani AR, MD; Moradian S, MD; Noorinia R, MD; Ziaei H, MD; Mahdavi AR, MD; Yaseri M, PhD; NaghibJ, MD; Toosi A, MD; Azarmina M, MD; Roohi K, MD; Javadi MA, MD Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran *Corresponding Author: mdkatibeh@yahoo.com Purpose: To describe the prevalence and risk factors of diabetic retinopathy (DR) in adults aged 40-80 years in Yazd province in 2011. Methods: This is a population-based survey on 2,320 urban and rural residents of Yazd province. Random multi-stage cluster sampling was employed in the survey. Diagnosis of diabetes was made upon past medical history and drug history or insulin injection and in cases without history of diabetes upon two fasting blood sugar exceeding 126 mg/dl. A detailed interview, eye examination and stereoscopic fundus photography were conducted for each eligible participant. DR definition and grading were based on ETDRS definition and the International Clinical Diabetic Retinopathy Disease Severity Scale. Results: Out of the eligible individuals, 2,098 cases (90.1%) participated in the study. The standardized prevalence of diabetes was 24.5% (95% confidence interval, 22.5-26.8%), 29.6% (25-34.3) of diabetics were diagnosed with DR. The prevalence of mild, moderate and severe forms of nonproliferative diabetic retinopathy (NPDR) and proliferative diabetic retinopathy (PDR) was 12.7% (95%CI, 9.5-15.8%), 11.8% (95%CI, 9-14.7%), 9.9% (95%CI, 6.6-13.3%), and 3.9% (2-5.8%), respectively. The prevalence of clinically significant macular edema (CSME) was 4.9% (2.7-7.2%) and vision-threatening diabetic retinopathy including severe NDPR, PDR and CSME was present in 11.1% (7.9-14.3%) of cases. Conclusion: This study showed that out of every four people above 40, one had diabetes and out of every three diabetic patients one had DR. The high prevalence rates of diabetes and DR indicate the need for adequate prevention and management strategies in the study population. Keywords: Diabetic Retinopathy, Population-based Study, Prevelence  Bina J Ophthalmol 2013; 18 (4): 375-391. Received: 26 July 2012 Accepted: 29 April 2013 ﺷﻴﻮع و ﻋﻮاﻣﻞ ﺧﻄﺮ رﺗﻴ ﻨﻮﭘﺎﺗﻲ دﻳﺎﺑﺘﻲ در ﺟﻤﻌﻴﺖ40 اﻟﻲ80 ﺳﺎل ﺷﻬﺮﺳﺘﺎن ﻳﺰد دآﺘﺮ ﻣﺤﻤﺪﺣﺴﻴﻦ دهﻘﺎن ١ ، دآﺘﺮ ﻣﺮﺿﻴﻪ آﺘﻴﺒﻪ ٢  ، دآﺘﺮ ﺣﻤﻴﺪ اﺣﻤﺪﻳﻪ ١ ، دآﺘﺮ ﻋﻠﻴﺮﺿﺎ رﻣﻀﺎﻧﻲ ٣ ، دآﺘﺮ ﺳﻴﺎﻣﻚ ﻣﺮادﻳﺎن ٣ ، دآﺘﺮ راﻣﻴﻦ ﻧﻮري ﻧﻴﺎ ۴ ، دآﺘﺮ ﺣﺴﻴﻦ ﺿﻴﺎﻳﻲ ٣ ، دﮐﺘﺮ ﻋﻠ ﻴ ﺮﺿﺎ ﻣﻬﺪو ي ۵ ، دآﺘﺮ ﻣﻬﺪي ﻳﺎﺳﺮي ۶ ، دآﺘﺮ ﺟﻠﻴﻞ ﻧﻘﻴﺐ ٧ ، دآﺘﺮ ادﻳ ﺐ ﻃﻮﺳﻲ ٧ ، دآﺘﺮ ﻣﺤﺴﻦ ﺁذرﻣﻴﻨﺎ ٣ ، دآﺘﺮ آﺒﺮي روﺣﻲ ٨ ، دآﺘﺮ ﻣﺤﻤﺪﻋﻠﻲ ﺟﻮادي ١ ﻫﺪﻑ: ﺑﺮﺭﺳﻲ ﻣﻴﺰﺍﻥ ﺷﻴﻮﻉ ﻭ ﺷﺪﺕ ﺭﺗﻴﻨﻮﭘﺎﺗﻲ ﺩﺭ ﺟﻤﻌﻴﺖ٤٠ ﺍﻟﻲ٨٠ ﺳﺎﻝ ﻣﺒﺘﻼ ﺑﻪ ﺩﻳﺎﺑﺖ ﺷﻬﺮﺳﺘﺎﻥ ﻳﺰﺩ ﺩﺭ ﺳﺎﻝ١٣٩٠ . ﺭﻭﺵ ﭘﮋﻭﻫﺶ: ﺍﻳﻦ ﻣﻄﺎﻟﻌﻪ ﺑﻪ ﺻﻮﺭﺕ ﻣﻘﻄﻌﻲ ﻭ ﻣﺒﺘﻨﻲ ﺑﺮ ﺟﻤﻌﻴﺖ ﺑـﺮ ﺭﻭﻱ٢٣٢٠ ﻧﻔـﺮ ﺍﺯ ﺟﻤﻌﻴـﺖ ﺷـﻬﺮﻱ ﻭ ﺭ ﻭﺳـﺘﺎﻳﻲ ﺳـﺎﮐﻦ ﺷﻬﺮﺳﺘﺎﻥ ﻳﺰﺩ ﮔﺮﻓﺖ ﺻﻮﺭﺕ. ﺭﻭﺵ ﻧﻤﻮﻧﻪ ﮔﻴﺮﻱ ﺧﻮﺷﻪ ﺍﻱ- ﺗﺼﺎﺩﻓﻲ ﭼﻨﺪ ﻣﺮﺣﻠﻪ ﺍﻱ ﻭ ﺗﺸﺨﻴﺺ ﺑﻴﻤﺎﺭﻱ ﺩﻳﺎﺑـﺖ ﺑـﺮ ﺍﺳـﺎﺱ ﺳـﻮﺍﺑﻖ ﭘﺰﺷﻜﻲ ﻗﺒﻠﻲ ﻭ ﻣﺼﺮﻑ ﺩﺍﺭﻭ ﻳﺎ ﺗﺰﺭﻳﻖ ﺍﻧﺴﻮﻟﻴﻦ ﻭ ﺩﺭ ﺍﻓﺮﺍﺩ ﺑﺪﻭﻥ ﺳﺎﺑﻘﻪ ﺩﻳﺎﺑﺖ ﺑﺮ ﺍﺳﺎﺱ ﺩﻭ ﻧﻮﺑﺖ ﻧﻤﻮﻧﻪ ﻗﻨﺪ ﺧﻮﻥ ﻧﺎﺷـﺘﺎ ﻣـﺴﺎﻭﻱ ﻳـﺎ ﺑﻴﺶ ﺍﺯmg/dl ١٢٦ ﻣﻄﺮﺡ ﮔﺮﺩﻳﺪ. ﺩﺭ ﻣﺮﺣﻠﻪ ﺑﻌﺪ ﺗﻤﺎﻡ ﻣﺒﺘﻼﻳﺎﻥ ﺷﻨﺎﺧﺘﻪ ﺷﺪﻩ ﻗﺒﻠﻲ ﻭ ﺟﺪﻳـﺪ ﺩﻳﺎﺑـﺖ ﺟﻬـﺖ ﺍﻧﺠـﺎﻡ ﺑﺮﺭﺳـﻲ ﻫـﺎﻱ ﺗﻜﻤﻴﻠﻲ ﺑﻪ ﻳﻚ ﺩﺭﻣﺎﻧﻲ ﻣﺮﮐﺰ ﻛﻪ ﺑﻪ ﻃﻮﺭ ﺧﺎﺹ ﺑﺮﺍﻱ ﺍﻧﺠﺎﻡ ﻣﻄﺎﻟﻌﻪ ﺗﺠﻬﻴﺰ ﺷﺪﻩ ﺑﻮﺩ ﺍﺭﺟـﺎﻉ ﺷـﺪﻧﺪ ﻭ ﺑﺮﺭﺳـﻲ ﻓـﺸﺎﺭ ﺧـﻮﻥ، ﺩﻳـﺲ ﻟﻴﭙﻴﺪﻣﻲ، ﻧﻔﺮﻭﭘﺎﺗﻲ، ﻫﻤﻮﮔﻠﻮﺑﻴﻦ ﺑﺪﻧﻲ، ﺗﻮﺩﻩ ﺷﺎﺧﺺC ۱ A ﻭ ﻣﻌﺎﻳﻨﺎﺕ ﻛﺎﻣﻞ ﭼﺸﻢ ﻭ ﻓﻮﻧﺪﻭﺱ ﻓﺘـﻮﮔﺮﺍﻓﻲ ﺍﺳﺘﺮﺋﻮﺳـﻜﻮﭘﻴﻚ ﺍﺯ ﻃﺮﻳـﻖ ﻣﺮﺩﻣﻚ ﻣﺘﺴﻊ ﺻﻮﺭﺕ ﭘﺬﻳﺮﻓﺖ. ﺩﺭ ﻧﻬﺎﻳﺖ ﻧﺘﺎﻳﺞ ﻣﻌﺎﻳﻨﺎﺕ ﺑﺎﻟﻴﻨﻲ ﻭ ﺗﺼﺎﻭﻳﺮ ﺷﺒﻜﻴﻪ ﺗﻮﺳﻂ ﺳﻪ ﻧﻔﺮ ﻓﻮﻕ ﺗﺨـﺼﺺ ﺷـﺒﻜﻴﻪ ﻣـﺸﺎﻫﺪﻩ ﻭ Archive of SID www.SID.ir