R Klein1, B E Klein, S E Moss. 1. MPH, Department of Ophthalmology and Visual Sciences, University of Wisconsin-Madison, 610 N Walnut St, 460 WARF, Madison, WI 53705-2397, USA.
Abstract
OBJECTIVE: To determine whether a 1-step or more or 2-step or more progression on the Early Treatment Diabetic Retinopathy Study retinopathy severity scale over a 4-year period is meaningful in predicting the subsequent incidence of proliferative diabetic retinopathy (PDR) and clinically significant macular edema (CSME) over the following 6 years. DESIGN: Population-based study of diabetic persons with 10 years of follow-up. SETTING AND PATIENTS: Eleven-county area in southern Wisconsin. There were 1025 persons with diabetes who had fundus photographs at baseline and at 4- and 10-year follow-up examinations. MAIN OUTCOME MEASURES: Incidence of PDR or CSME between the 4- and 10-year follow-up examinations as determined by masked grading of color stereoscopic fundus photographs of 7 standard fields. RESULTS: In a univariate analysis, those with 1 or more steps of progression (n = 551) over the first 4 years of the study were significantly (P<.0001) more likely to develop PDR over the next 6 years than those with no progression (n = 474) (26% vs 4%) (relative risk, 5.85; 95% confidence interval, 4.05-8.47). Similarly, those with 2 or more (n = 364) (33%) or 3 or more (n = 231) (41%) steps of progression over the first 4 years of the study were significantly (P<.0001) more likely to develop PDR over the next 6 years than those with lesser progression (n = 661 [7%] and n = 794 [9%], respectively) (relative risk, 5.10; 95% confidence interval, 3.83-6.80; and relative risk, 4.61; 95% confidence interval, 3.57-5.99, respectively). Similar associations were apparent at every level of retinopathy, duration of diabetes, and glycosylated hemoglobin, and by type of diabetes at baseline. There were also associations between retinopathy progression and incidence of CSME. CONCLUSIONS: It seems that 1 or more or 2 or more steps of progression of retinopathy over a 4-year period strongly predict the development of PDR over the next 6 years. Therefore, using these end points of progression would result in the need for fewer subjects or shorter follow-up in some clinical trials.
OBJECTIVE: To determine whether a 1-step or more or 2-step or more progression on the Early Treatment Diabetic Retinopathy Study retinopathy severity scale over a 4-year period is meaningful in predicting the subsequent incidence of proliferative diabetic retinopathy (PDR) and clinically significant macular edema (CSME) over the following 6 years. DESIGN: Population-based study of diabeticpersons with 10 years of follow-up. SETTING AND PATIENTS: Eleven-county area in southern Wisconsin. There were 1025 persons with diabetes who had fundus photographs at baseline and at 4- and 10-year follow-up examinations. MAIN OUTCOME MEASURES: Incidence of PDR or CSME between the 4- and 10-year follow-up examinations as determined by masked grading of color stereoscopic fundus photographs of 7 standard fields. RESULTS: In a univariate analysis, those with 1 or more steps of progression (n = 551) over the first 4 years of the study were significantly (P<.0001) more likely to develop PDR over the next 6 years than those with no progression (n = 474) (26% vs 4%) (relative risk, 5.85; 95% confidence interval, 4.05-8.47). Similarly, those with 2 or more (n = 364) (33%) or 3 or more (n = 231) (41%) steps of progression over the first 4 years of the study were significantly (P<.0001) more likely to develop PDR over the next 6 years than those with lesser progression (n = 661 [7%] and n = 794 [9%], respectively) (relative risk, 5.10; 95% confidence interval, 3.83-6.80; and relative risk, 4.61; 95% confidence interval, 3.57-5.99, respectively). Similar associations were apparent at every level of retinopathy, duration of diabetes, and glycosylated hemoglobin, and by type of diabetes at baseline. There were also associations between retinopathy progression and incidence of CSME. CONCLUSIONS: It seems that 1 or more or 2 or more steps of progression of retinopathy over a 4-year period strongly predict the development of PDR over the next 6 years. Therefore, using these end points of progression would result in the need for fewer subjects or shorter follow-up in some clinical trials.
Authors: Susan Vitale; Elvira Agrón; Traci E Clemons; Tiarnan D L Keenan; Amitha Domalpally; Ronald P Danis; Emily Y Chew Journal: JAMA Ophthalmol Date: 2020-06-01 Impact factor: 7.389
Authors: Juan E Grunwald; Maxwell Pistilli; Gui-Shuang Ying; Ebenezer Daniel; Maureen Maguire; Dawei Xie; Jason Roy; Revell Whittock-Martin; Candace Parker Ostroff; Joan C Lo; Raymond R Townsend; Crystal A Gadegbeku; James P Lash; Jeffrey C Fink; Mahboob Rahman; Harold I Feldman; John W Kusek Journal: JAMA Ophthalmol Date: 2019-07-01 Impact factor: 7.389
Authors: Michael Mauer; Bernard Zinman; Robert Gardiner; Samy Suissa; Alan Sinaiko; Trudy Strand; Keith Drummond; Sandra Donnelly; Paul Goodyer; Marie Claire Gubler; Ronald Klein Journal: N Engl J Med Date: 2009-07-02 Impact factor: 91.245
Authors: Juan E Grunwald; Maxwell Pistilli; Gui-Shuang Ying; Maureen G Maguire; Ebenezer Daniel; Revell Whittock-Martin; Candace Parker-Ostroff; Douglas Jacoby; Alan S Go; Raymond R Townsend; Crystal Ann Gadegbeku; James P Lash; Jeffrey Craig Fink; Mahboob Rahman; Harold Feldman; John W Kusek; Dawei Xie Journal: Br J Ophthalmol Date: 2020-06-05 Impact factor: 4.638
Authors: Inês P Marques; Sophie Kubach; Torcato Santos; Luís Mendes; Maria H Madeira; Luis de Sisternes; Diana Tavares; Ana Rita Santos; Warren Lewis; Conceição Lobo; Mary K Durbin; José Cunha-Vaz Journal: J Clin Med Date: 2021-05-25 Impact factor: 4.241