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5 600位中的4 323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4 323例患者中，男性视网膜疾病患者有2 563例(59.29%)，多于女性1 760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。

METHODS: It 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.

CONCLUSION: DR was the most common retinal vascular disorder. Retinal disorders appear to be a major public health problem in India. 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.