Incidence and Progression of Diabetic Retinopathy During 17 Years of a Population-Based Screening Program in England
نویسندگان
چکیده
OBJECTIVE To estimate the incidence of diabetic retinopathy in relation to retinopathy grade at first examination and other prognostic characteristics. RESEARCH DESIGN AND METHODS This was a dynamic cohort study of 20,686 people with type 2 diabetes who had annual retinal photography up to 14 times between 1990 and 2006. Cumulative and annual incidence rates were estimated using life tables, and risk factors for progression were identified using Cox regression analysis. RESULTS Of 20,686 patients without proliferative diabetic retinopathy (PDR) or sight-threatening maculopathy at their first retinal examination (baseline), 16,444 (79%) did not have retinopathy, 3,632 (18%) had nonproliferative retinopathy, and 610 (2.9%) had preproliferative retinopathy. After 5 years, few patients without retinopathy at baseline developed preproliferative retinopathy (cumulative incidence 4.0%), sight-threatening maculopathy (0.59%), or PDR (0.68%); after 10 years, the respective cumulative incidences were 16.4, 1.2, and 1.5%. Among those with nonproliferative (background) retinopathy at baseline, after 5 years [corrected] 23% developed preproliferative retinopathy, 5.2% developed maculopathy, and 6.1% developed PDR; after 10 years, the respective cumulative incidences were 53%, 9.6%, and 11%. Patients with nonproliferative retinopathy at baseline were five times more likely to develop preproliferative, PDR, or maculopathy than those without retinopathy at baseline (adjusted hazard ratio 5.0 [95% CI 4.4-5.6]). CONCLUSIONS Few patients without diabetic retinopathy at the initial screening examination developed preproliferative retinopathy, PDR, or sight-threatening maculopathy after 5-10 years of follow-up. Screening intervals longer than a year may be appropriate for such patients.
منابع مشابه
بررسی بروز 4 ساله رتینوپاتی دیابتی و عوامل مؤثر بر آن در دیابت نوع 2
Introduction: It seems that improvement in care and new treatment and screening methods along with better control of diabetes mellitus (DM) has led to a change in incidence of diabetic complications, especially diabetic retinopathy .This study was performed to assess the 4 years incidence rate of diabetic retinopathy in patients with type II diabetes and factors affecting its progression. Meth...
متن کاملمیزان بروز میکروآلبومینوری و عوامل خطر همراه در بیماران دیابتی نوع 2
Background: Microalbuminuria represents the earliest clinical of renal involvement and reflects the progression of diabetic nephropathy and increased risk of mortality in diabetic patients. The incidence of diabetic nephropathy in type 2 diabetes differs widely by race .The aim of this study was to determine the incidence of and risk factors for microalbuminuria in type 2 diabetic patients. ...
متن کاملPlanning and Developing Services for Diabetic Retinopathy in Sub-Saharan Africa
Background Over the past few decades diabetes has emerged as an important non-communicable disease in SubSaharan Africa (SSA). Sight loss from Diabetic Retinopathy (DR) can be prevented with screening and early treatment. The objective of this paper is to outline the required actions and considerations in the planning and development of DR screening services. Methods A multiple-case study app...
متن کاملEconomic Evaluation of Screening for Type 2 Diabetes: Case Study of Iran
Abstract Objective: In health economics, one of the important methods of economic evaluation is cost-effectiveness analysis. The usual procedure in this method is to consider effectiveness of Disability-Adjusted Life Years (DALYs) as a measure criterion. Material and Methods: This was a cross sectional study of economic assessment type or Cost-Effectiveness. All over 30 years old population o...
متن کاملComparison of axial length of the eye in patients with diabetic retinopathy and non diabetics
Introduction: To compare the axial length of globe in patients with diabetic retinopathy with that in normal population and to evaluate its role in the progression of diabetic retinopathy. Methods: 150 patients with diabetic retinopathy in both eyes were compared with 150 age and sex matched non diabetic patients, referred to Motahari retina clinic of Shiraz, during fall 2000. The axial length...
متن کامل