Objective: Quality of life and the influencing factors in patients with diabetic retinopathy before and after receiving treatment of pan-retinal photocoagulation (PRP) were studied. Methods: Prospective study. A total of 55 diabetic retinopathy patients were collected at Beijing Friendship Hospital, Capital Medical University from November 2016 to August 2017 and were surveyed using Vision Function Questionaire (VFQ-25) to evaluate their quality of life before and 3 months after treatment with PRP. According to diagnostic criteria, the patients were divided into two groups: severe nonproliferative diabetic retinopathy(NPDR) and proliferative diabetic retinopathy group(PDR). SPSS was used for statistical analysis. Results: The score of VFO-25 general health before PRP treatment was 62.73±14.20, obviously lower the other sub scale scores of VFO-25. The results of variance analysis there was significant statistical difference between the composite score and the different educational levels (F=2.94, P<0.05), but there was no statistical difference for diabetes duration (F=3.01, P<0.05). The composite score was significantly significance between the severe NPDR and PDR group(t=8.95, P<0.05). The patients with hyperlipidemia (t=-3.21, P<0.05), hypertension(t=-2.32, P<0.05) and renal insufficiency(t=-2.05, P=0.045) has lower composite score. There was high relationship for age among the factors of worse logMAR vision, better logMAR vision and age (r=-0.47, P<0.05; r=-0.38, P<0.05; r=-0.26, P<0.05). The scores of VFQ-25 subscale of social function (t=-2.07, P<0.05) , role limitations (t=-2.38, P<0.05) , dependency (t=-2.99, P<0.05) and mental health (t=-2.26, P<0.05) was significantly increased after treatment of PRP. The score of ocular pain was obviously decreased (t=4.19, P<0.001) ; there were no significance in other sub scale scores. Conclusions: This study showed that the degree of visual acuity, the severity of DR and age were an important factor affecting the quality of life in DR patients. PRP therapy could improve the mental health and social field of DR patients, but failed to improve the scores of other visual functions in the patients. (Chin J Ophthalmol, 2018, 54:611-616).
目的： 评估糖尿病视网膜病变（DR）患者全视网膜激光光凝治疗（PRP）前后视觉相关生活质量变化及其相关影响因素。 方法： 前瞻性研究。收集2016年11至2017年8月于北京友谊医院眼科双眼行PRP治疗的患者55例，其中男性33例，女性22例；年龄（57.2±10.0）岁。采用视功能相关的生活质量量表（VFQ-25）中文版对患者PRP治疗前及治疗后3个月进行问卷调查。对不同年龄段、糖尿病病程、DR表现、学历、其他全身性疾病情况的患者量表各项评分进行比较。分组因素与量表评分的分析使用方差分析、独立样本t检验或Pearson及Spearman相关分析。PRP治疗前后的量表评分对比采用配对t检验。 结果： PRP治疗前所有患者VFQ-25整体健康评分为（62.73±14.20）分。教育程度为文盲、小学、初中、高中及大学及以上的受试者综合评分分别为（57.00±4.11）、（73.84±9.51）、（75.02±13.66）、（78.44±2.43）、（88.12±7.71）分，差异有统计学意义（F=2.94，P=0.029）。糖尿病病程<5年、5~10年及>10年的受试者，综合评分分别为（82.33±6.84）、（78.93±12.71）、（71.46±12.69）分，差异无统计学意义（F=3.01，P=0.06）。严重NPDR受试者综合评分为（86.74±8.41）分，PDR为（67.06±7.83）分，PDR患者综合评分较低（t=8.95，P<0.001）。伴有高血脂（t=-3.21，P<0.05）、高血压（t=-2.32，P<0.05）、肾功能不全（t=-2.05，P<0.05）等因素者，其综合评分低。综合评分与较差logMAR视力、较好logMAR视力及年龄显著相关（r=-0.47，-0.38，-0.26；P<0.05）。PRP治疗后患者在VFQ-25亚量社会功能（t=-2.07，P<0.05）、社会角色限制（t=-2.38，P<0.05）、依赖程度（t=-2.99，P<0.05）及精神健康状况（t=-2.26，P<0.05）等方面的评分均有所提高；然而在眼部疼痛评分有所下降（t=4.19，P<0.05）；在综合评分及其他亚量表方面如整体健康状况、生活质量综合评分、总体视力、近距离活动、远距离活动、驾车、色觉、周边视力（t=1.42，P<0.05）等方面差异均无统计学意义。 结论： 本研究显示视力程度及DR严重程度是影响DR患者生活质量的一个重要影响因素；PRP治疗可改善DR患者心理健康及社会领域方面的评分，但未能提高患者其他视功能相关方面的评分。（中华眼科杂志，2018，54：611-616）.
Keywords: Diabetic retinopathy; Laser coagulation; Quality of life.