Incidence of Diabetic Retinopathy and Blindness: A Population-based Study in Rochester, Minnesota

Abstract

Among the 1135 Rochester residents discovered to have diabetes in the period 1945-69, the prevalence of retinopathy was 2.6% at the time of initial diagnosis. Among those free of retinopathy at diagnosis of diabetes, the subsequent incidence of any retinopathy was 17.4 per 1000 person-years and for proliferative retinopathy alone was 1.6 per 1000 person-years, based on 12,000 person-years of follow-up. The incidence rate of retinopathy was almost three times greater among residents with insulin-dependent (IDDM) than with non-insulin-dependent diabetes (NIDDM); however, the actual number of retinopathy cases was over four times greater among the more numerous residents with NIDDM. By 20 yr after diagnosis of diabetes, the cumulative incidence of retinopathy approached 70% among IDDM subjects and was 30% and 36%, respectively, among the obese and nonobese NIDDM residents. The epidemiologic patterns for proliferative retinopathy were qualitatively similar to those for nonproliferative retinopathy. The risk of blindness was greater among those with proliferative than with nonproliferative retinopathy but was substantial even for those without retinopathy. Most blindness was caused by factors other than isolated diabetic retinopathy.

Active prevention in diabetic eye disease

“…Nielsen reported a 1-year blind-ness incidence of 3.7% in insulin-treated diabetic patients (1984a). Dwyer and associates estimated a 4-year rate of blindness of 1.6% in all diabetic persons (Dwyer et al 1985). Sjolie & Green found an annual incidence rate of blindness of approximately 1 O/O (Sjdie & Green 1987).…”

“…One patient developed moderate, visual loss and 2 with moderate visual impairment at baseline improved over the 4-year period. Relatively few prospective population-based studies have been made on the incidence of visual impairment due to diabetes (Nielsen 1984a,b;Dwyer et al 1985;Sjalie & Green 1987;Moss et al 1988;Agardh et al 1993). In the Wisconsin Epidemiology Study, Moss and associates found a 4-years blindness incidence rate of 1.5% in young onset (< 30 years) patients (Moss et al 1988).…”

Markers of Insulin Resistance Are Strong Risk Factors for Retinopathy Incidence in Type 1 Diabetes: The EURODIAB Prospective Complications Study

“…etinopathy is the most common complication of type 1 diabetes, affecting 70-100% of all patients (1)(2)(3). The only proven preventive measure is strict glycemic control (4), which alone is not wholly satisfactory because retinopathy still develops in ϳ12% of intensively treated diabetic patients, and the institution of such control places great demands on both patients and health care systems, questioning its true practicality (5).…”

A simulation model of the cost of the incidence of IDDM in Spain

“…Thus, IDDM is of major importance in health care planning as it affects health primarily through its chronic multisystem complications, rather than by acute metabolic crises related to insulin deficiency [2]. These chronic conditions include diabetic retinopathy [3,4], coronary artery disease [4][5][6], nephropathy [7], neuropathy [8], cerebrovascular disease [8][9][10], and peripheral vascular disease (PVD) [11][12]. Treating IDDM therefore requires a variety of health care resources including hospital physician and general practitioner time.…”