OBJECTIVE: We conducted a cohort study to determine the incidence and progression of diabetic retinopathy (DR) in a Chinese population with type 2 diabetes mellitus in a district hospital in Hong Kong, and to identify the risk factors associated with the development and progression of DR over 4 years. RESEARCH DESIGN AND METHODS: A total of 413 type 2 diabetic patients who followed up in our diabetic clinic and had a diabetic complication screening performed in 2001 were studied. The final analysis included 354 subjects (85.7%) after a mean follow-up period of 4.2 years. The severity of DR was graded according to the modified Early Treatment Diabetic Retinopathy Study (ETDRS). The relationship between clinical variables and DR development and progression was determined. RESULTS: The baseline prevalence of DR was 39.2%. On 4-year follow-up, the incidence of DR was 20.3% (43 of 212). In those with baseline DR, 34.7% (42 of 121) progressed by >or=2 steps in ETDRS. On multivariate analysis, a high baseline glycosylated hemoglobin (HbA(1c)) was the only predictor of DR development, while macroalbuminuria and high mean HbA(1c) predicted progression. Regression of DR, defined by a >or=2-step decrement in ETDRS, occurred in 13.2% (12 of 91) of subjects and was associated with lower baseline HbA(1c) and absence of albuminuria. CONCLUSION: The incidence of DR in our study was similar to--but progression of DR was higher than--those reported in Caucasians. More frequent retinal screening should be offered to those with baseline DR, high HbA(1c), or albuminuria. Good glycemic control is important in order to prevent the development and progression of DR, and can lead to regression of DR.
OBJECTIVE: We conducted a cohort study to determine the incidence and progression of diabetic retinopathy (DR) in a Chinese population with type 2 diabetes mellitus in a district hospital in Hong Kong, and to identify the risk factors associated with the development and progression of DR over 4 years. RESEARCH DESIGN AND METHODS: A total of 413 type 2 diabeticpatients who followed up in our diabetic clinic and had a diabetic complication screening performed in 2001 were studied. The final analysis included 354 subjects (85.7%) after a mean follow-up period of 4.2 years. The severity of DR was graded according to the modified Early Treatment Diabetic Retinopathy Study (ETDRS). The relationship between clinical variables and DR development and progression was determined. RESULTS: The baseline prevalence of DR was 39.2%. On 4-year follow-up, the incidence of DR was 20.3% (43 of 212). In those with baseline DR, 34.7% (42 of 121) progressed by >or=2 steps in ETDRS. On multivariate analysis, a high baseline glycosylated hemoglobin (HbA(1c)) was the only predictor of DR development, while macroalbuminuria and high mean HbA(1c) predicted progression. Regression of DR, defined by a >or=2-step decrement in ETDRS, occurred in 13.2% (12 of 91) of subjects and was associated with lower baseline HbA(1c) and absence of albuminuria. CONCLUSION: The incidence of DR in our study was similar to--but progression of DR was higher than--those reported in Caucasians. More frequent retinal screening should be offered to those with baseline DR, high HbA(1c), or albuminuria. Good glycemic control is important in order to prevent the development and progression of DR, and can lead to regression of DR.
Authors: Douglas A Stram; Xuejuan Jiang; Rohit Varma; Mina Torres; Bruce S Burkemper; Farzana Choudhury; Ronald Klein; W James Gauderman; Roberta McKean-Cowdin Journal: Ophthalmol Retina Date: 2017-08-16
Authors: Miguel Á Salinero-Fort; Francisco Javier San Andrés-Rebollo; Carmen de Burgos-Lunar; Francisco Jesús Arrieta-Blanco; Paloma Gómez-Campelo Journal: PLoS One Date: 2013-10-17 Impact factor: 3.240
Authors: Rajan Shukla; Murthy V S Gudlavalleti; Souvik Bandyopadhyay; Raghupathy Anchala; Aashrai Sai Venkat Gudlavalleti; A T Jotheeswaran; Srikrishna S Ramachandra; Vivek Singh; Praveen Vashist; Komal Allagh; Hira Pant Ballabh; Clare E Gilbert Journal: Indian J Endocrinol Metab Date: 2016-04