RETINAL MICROANEURYSM COUNTS AND 10-YEAR PROGRESSION OF DIABETIC-RETINOPATHY
RETINAL MICROANEURYSM COUNTS AND 10-YEAR PROGRESSION OF DIABETIC-RETINOPATHY
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DOI：
10.1001/archopht.1995.01100110046024
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发表时间：
1995-11-01
影响因子：
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通讯作者：
KLEIN, BEK
中科院分区：
文献类型：
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作者：
KLEIN, R;MEUER, SM;KLEIN, BEK
目的：探讨视网膜微动脉瘤数量的变化与10年进展为显著性视网膜病变、增殖性视网膜病变和临床显著性黄斑水肿的关系。设计：以人群为基础的研究，对年轻和老年糖尿病患者进行了10年的随访。背景和患者：在威斯康星州南部的11个县，189名基线照片中只有视网膜微动脉瘤的糖尿病患者参加了4年和10年的随访检查。结果测量：中度非增殖性糖尿病视网膜病变或更严重，增殖性视网膜病变，或临床显著黄斑水肿的十年发生率，由七个标准视场立体彩色眼底照片的模糊分级确定。结果：视网膜微动脉瘤数量的增加以及4年随访时视网膜微动脉瘤数量与基线数量之比与10年随访时增殖性视网膜病变或临床显著性黄斑水肿的发生率呈正相关。在10年随访中，微动脉瘤数量从基线到2年随访时增加16个或更多的眼睛发生增殖性视网膜病变的可能性约为4.6倍，临床上显著的黄斑水肿的可能性约为9.1倍。在10年随访期间，视网膜微动脉瘤数量与基线数量之比为3或更大的眼睛发生增殖性视网膜病变的可能性是3.4倍，临床显著性黄斑水肿的可能性是6.7倍。在控制糖化血红蛋白水平和糖尿病类型后，这些关系仍然存在。结论：使用立体彩色眼底照片进行微动脉瘤计数是视网膜病变进展的早期重要指标，在一些临床试验中可以作为严重病变的替代终点。
Objective: To determine the relationship of change in the number of retinal microaneurysms to the 10-year progression to significant retinopathy, proliferative retinopathy, and clinically significant macular edema.Design: Population-based study of persons with younger-and older-onset diabetes with 10 years of follow-up.Setting and Patients: Eleven-county area in southern Wisconsin, where 189 patients with diabetes who had only retinal microaneurysms in photographs at baseline participated in 4- and 10-year follow-up examinations.Outcome Measures: Ten-year incidence of moderate nonproliferative diabetic retinopathy or worse, proliferative retinopathy, or clinically significant macular edema as determined by masked grading of stereoscopic color fundus photographs of seven standard fields.Results: The increase in the number of retinal microaneurysms and the ratio of the number of retinal microaneurysms at the 4-year follow-up to the number at baseline were positively associated with incidence ofproliferative retinopathy or clinically significant macular edema at the 10-year follow-up. Proliferative retinopathy was approximately 4.6 times and clinically significant macular edema was approximately 9.1 times more likely to develop at 10-year follow-up in eyes in which the number of microaneurysms increased by 16 or more from baseline to the di-year follow-up than in eyes with no increase. Proliferative retinopathy was 3.4 times and clinically significant macular edema was 6.7 times more likely to develop at 10-year follow-up in eyes that had ratios of 3 or greater of the number of retinal microaneurysms at the dr-year follow-up to the number at baseline than in eyes in which the ratios were smaller. These relationships remained after controlling for the level of glycosylated hemoglobin and type of diabetes.Conclusions: Microaneurysm counts using stereoscopic color fundus photographs are an early important measure of progression of retinopathy and may serve as a surrogate end point for severe change in some clinical trials.