Proposed international clinical diabetic retinopathy and diabetic macular edema disease severity scales

Wilkinson, Charles P.; Ferris, Frederick L.; Klein, Michael L.; Lee, Paul P.; Agardh, Carl‐David; Davis, Matthew D.; Dills, Diana; Kampik, Anselm; Pararajasegaram, R.; Verdaguer, T Juan

doi:10.1016/s0161-6420(03)00475-5

Cited by 2,905 publications

(2,140 citation statements)

References 7 publications

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“…Stage of DR and DME were determined according to the International Clinical Diabetic Retinopathy Severity Scale (Wilkinson et al. 2003). The eye with the most severe retinopathy was included in further analyses.…”

Section: Methodsmentioning

confidence: 99%

Risk factors for development and progression of diabetic retinopathy in Dutch patients with type 1 diabetes mellitus

Schreur

Asten

et al. 2018

Acta Ophthalmologica

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PurposeTo investigate risk factors for the development and progression of diabetic retinopathy (DR) and long‐term visual outcomes in Dutch patients with type 1 diabetes mellitus (T1DM).MethodsCumulative incidences were calculated for DR, vision‐threatening DR (VTDR), defined as (pre)proliferative DR and diabetic macular oedema, and best‐corrected visual acuity (BCVA) <0.5 and <0.3 at the most recent eye examination. The following factors were assessed: duration of diabetes, age of onset of T1DM, gender, mean HbA1c, HbA1c variability (defined as coefficient of variation of five separate HbA1c measurements), mean arterial blood pressure, body mass index, albuminuria and lipid profile. We used multivariable Cox regression models to identify factors associated with DR development and progression to VTDR.ResultsWe found 25‐year cumulative incidences of 63% for DR, 21% for VTDR, 2% for BCVA <0.5, and 1% for BCVA <0.3. Mean HbA1c (HR 1.023, p < 0.001), HbA1c variability (HR 1.054, p < 0.001), age of onset of T1DM (HR 1.024, p < 0.001), HDL cholesterol (HR 0.502, p = 0.002) and total cholesterol (HR 1.210, p = 0.029) showed an independent association with faster development of any form of DR. The mean HbA1c (HR 1.023, p < 0.001) and the presence of albuminuria (HR 2.940, p = 0.028) were associated with faster progression to VTDR.ConclusionThese data show relatively low cumulative incidences of DR, VTDR and visual impairment. Higher mean HbA1c, HbA1c variability, age of onset of T1DM and total cholesterol were independently associated with the risk of DR development, and a protective association was found for HDL cholesterol in subjects with T1DM. Mean HbA1c and presence of albuminuria were associated with progression of DR.

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Section: Methodsmentioning

confidence: 99%

Risk factors for development and progression of diabetic retinopathy in Dutch patients with type 1 diabetes mellitus

Schreur

Asten

et al. 2018

Acta Ophthalmologica

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“…Anti‐vascular endothelial growth factor therapy may be used to treat patients with diabetic macular oedema 84.…”

Section: Chronic Complications Of Diabetesmentioning

confidence: 99%

Standards of care for type 2 diabetes in China

Weng

Jia

et al. 2016

Diabetes Metabolism Res

262

280

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“…Exclusion criteria were: (1) previous vitreoretinal surgery; (2) photocoagulation in the preceding 6 months; (3) recent vitreous haemorrhage (less than 3 months before vitrectomy) or intravitreous haemoglobin higher than 5 mg/ml; (4) renal failure (creatinine ≥120 μmol/l); and (5) other chronic diseases apart from diabetes. For diabetic retinopathy classification we used the International Clinical Diabetic Retinopathy Severity Scale [16]. In accordance with this classification, NPDR samples were from patients with mild (n=8) and moderate (n=2) NPDR.…”

Section: Participants and Sample Selectionmentioning

confidence: 99%

Interphotoreceptor retinoid-binding protein (IRBP) is downregulated at early stages of diabetic retinopathy

et al. 2009

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Aims/hypothesis Interphotoreceptor retinoid-binding protein (IRBP) plays a major role in the visual cycle and is essential to the maintenance of photoreceptors. The aim of this study was to determine whether a decrease in IRBP production exists in the early stages of diabetic retinopathy. Methods Vitreous samples from diabetic patients with proliferative and non-proliferative diabetic retinopathy (PDR, NPDR), and from non-diabetic patients with macular hole (control group) were selected for IRBP quantitative assessment by proteomic analysis (fluorescence-based difference gel electrophoresis) and western blot. Human post mortem eyes (n=16) from diabetic donors without clinically detectable retinopathy and from non-diabetic donors (n=16) were used to determine IRBP (also known as RBP3) mRNA levels (RT-PCR) and protein content (western blot and confocal microscopy). Retinal neurodegeneration was assessed by measuring glial fibrillar acidic protein (GFAP) and the apoptotic rate. Y79 human retinoblastoma cells were used to test the effects of glucose, TNF-α and IL-1β on IRBP expression and IRBP levels. Results Intravitreous IRBP concentration was significantly lower in PDR

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Proposed international clinical diabetic retinopathy and diabetic macular edema disease severity scales

Cited by 2,905 publications

References 7 publications

Risk factors for development and progression of diabetic retinopathy in Dutch patients with type 1 diabetes mellitus

Risk factors for development and progression of diabetic retinopathy in Dutch patients with type 1 diabetes mellitus

Standards of care for type 2 diabetes in China

Interphotoreceptor retinoid-binding protein (IRBP) is downregulated at early stages of diabetic retinopathy

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