Assessing the Natural Course of Diabetic Retinopathy: A Population-Based Study in Kinmen, Taiwan

Tung, Tao‐Hsin; Chen, Shih‐Jen; Shih, Hui-Chuan; Chou, Pesus; Li, An-Fei; Shyong, Mong‐Ping; Lee, Feng-Li; Liu, Jorn‐Hon

doi:10.1080/09286580600826637

Cited by 33 publications

(47 citation statements)

References 21 publications

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“…In addition, the average transition time from the mildest form of diabetic retinopathy to proliferative retinopathy in Tung et al . 's study was 10.8 years . Thus, a 2‐year screening interval in people with no diabetic retinopathy would still be less than one fifth of this interval.…”

Section: Resultsmentioning

confidence: 91%

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Screening intervals for diabetic retinopathy and incidence of visual loss: a systematic review

et al. 2013

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Screening for diabetic retinopathy can help to prevent this complication, but evidence regarding frequency of screening is uncertain. This paper systematically reviews the published literature on the relationship between screening intervals for diabetic retinopathy and the incidence of visual loss. The PubMed and EMBASE databases were searched until December 2012. Twenty five studies fulfilled the inclusion criteria, as these assessed the incidence/prevalence of sight-threatening diabetic retinopathy in relation to screening frequency. The included studies comprised 15 evaluations of real-world screening programmes, three studies modelling the natural history of diabetic retinopathy and seven cost-effectiveness studies. In evaluations of diabetic retinopathy screening programmes, the appropriate screening interval ranged from one to four years, in people with no retinopathy at baseline. Despite study heterogeneity, the overall tendency observed in these programmes was that 2-year screening intervals among people with no diabetic retinopathy at diagnosis were not associated with high incidence of sight-threatening diabetic retinopathy. The modelling studies (non-economic and economic) assessed a range of screening intervals (1-5 years). The aggregated evidence from both the natural history and cost-effectiveness models favors a screening interval >1 year, but ≤2 years. Such an interval would be appropriate, safe and cost-effective for people with no diabetic retinopathy at diagnosis, while screening intervals ≤1 year would be preferable for people with pre-existing diabetic retinopathy. A 2-year screening interval for people with no sight threatening diabetic retinopathy at diagnosis may be safely adopted. For patients with pre-existing diabetic retinopathy, a shorter interval ≤1 year is warranted.

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Section: Resultsmentioning

confidence: 91%

“…The study of Tung et al . did not comprehensively describe the screening intervals/strategies and made no clear distinction between screening and surveillance once diabetic retinopathy is detected. Thus, the length of the surveillance once diabetic retinopathy is diagnosed was unclear.…”

Section: Resultsmentioning

confidence: 99%

Screening intervals for diabetic retinopathy and incidence of visual loss: a systematic review

et al. 2013

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“…The previous study suggested the average time for the development of NPDR from no DR was estimated as 14.5 years [44]. We indirectly measured the average time to develop DR as a calculation of duration of diabetes for the first diagnosis of DR for the patients who reached each stage of DR. As a result, the mean duration for the development of mild NPDR was approximately 14.8 years, and progression time to moderate NPDR, severe NPDR, or PDR was 16.7 and 17.3 years, which was similar to previous studies.…”

Section: Discussionmentioning

confidence: 99%

Clinical Course and Risk Factors of Diabetic Retinopathy in Patients with Type 2 Diabetes Mellitus in Korea

et al. 2016

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BackgroundWe investigated clinical course and risk factors for diabetic retinopathy (DR) in patients with type 2 diabetes mellitus (T2DM).MethodsA total of 759 patients with T2DM without DR were included from January 2001 to December 2004. Retinopathy evaluation was performed at least annually by ophthalmologists. The severity of the DR was classified into five categories according to the International Clinical Diabetic Retinopathy Severity Scales.ResultsOf the 759 patients, 523 patients (68.9%) completed the follow-up evaluation. During the follow-up period, 235 patients (44.9%) developed DR, and 32 patients (13.6%) progressed to severe nonproliferative DR (NPDR) or proliferative DR (PDR). The mean duration of diabetes at the first diagnosis of mild NPDR, moderate NPDR, and severe NPDR or PDR were 14.8, 16.7, and 17.3 years, respectively. After adjusting multiple confounding factors, the significant risk factors for the incidence of DR risk in patients with T2DM were old age, longer duration of diabetes, higher mean glycosylated hemoglobin (HbA1c), and albuminuria. Even in the patients who had been diagnosed with diabetes for longer than 10 years at baseline, a decrease in HbA1c led to a significant reduction in the risk of developing DR (hazard ratio, 0.73 per 1% HbA1c decrement; 95% confidence interval, 0.58 to 0.91; P=0.005).ConclusionThis prospective cohort study demonstrates that glycemic control, diabetes duration, age, and albuminuria are important risk factors for the development of DR. More aggressive retinal screening for T2DM patients diagnosed with DR should be required in order to not miss rapid progression of DR.

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“…[20] The estimated average time of developing DR from none existence to retinopathy is 26.5 years in Taiwan. [21] This enables the clinician to monitor the patient over time and to institute intervention measures promptly. The majority of the patients studied had NIDDM and were treated with oral hypoglycemic agents and dietary modification.…”

Section: Discussionmentioning

confidence: 99%

Pattern of diabetic retinopathy in Kano, Nigeria

Abdu

Mohammed

2012

Ann Afr Med

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Assessing the Natural Course of Diabetic Retinopathy: A Population-Based Study in Kinmen, Taiwan

Cited by 33 publications

References 21 publications

Screening intervals for diabetic retinopathy and incidence of visual loss: a systematic review

Screening intervals for diabetic retinopathy and incidence of visual loss: a systematic review

Clinical Course and Risk Factors of Diabetic Retinopathy in Patients with Type 2 Diabetes Mellitus in Korea

Pattern of diabetic retinopathy in Kano, Nigeria

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