Incidence and progression of diabetic retinopathy during 17 years of a population-based screening program in England.
Incidence and progression of diabetic retinopathy during 17 years of a population-based screening program in England.
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DOI：
10.2337/dc11-0943
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发表时间：
2012-03
期刊：
影响因子：
16.2
通讯作者：
Bachmann MO
中科院分区：
文献类型：
--
作者：
Jones CD;Greenwood RH;Misra A;Bachmann MO
评估糖尿病视网膜病变的发病率与首次检查时视网膜病变分级和其他预后特征的关系。这是一项动态队列研究，研究对象为20,686名2型糖尿病患者，他们在1990年至2006年期间每年接受视网膜摄影多达14次。使用寿命表估计累积和年发病率，并使用考克斯回归分析确定进展的风险因素。在20，686例首次视网膜检查（基线）时无增殖性糖尿病视网膜病变（PDR）或危及视力的黄斑病变的患者中，16，444例（79%）无视网膜病变，3，632例（18%）有非增殖性视网膜病变，610例（2.9%）有增殖前视网膜病变。5年后，基线时无视网膜病变的患者很少发生增殖前视网膜病变（累积发生率4.0%）、威胁视力的黄斑病变（0.59%）或PDR（0.68%）; 10年后，相应的累积发生率分别为16.4%、1.2%和1.5%。在基线时患有非增殖性（背景）视网膜病变的患者中，1年后23%发生增殖前视网膜病变，5.2%发生黄斑病变，6.1%发生PDR; 10年后，各自的累积发生率分别为53%、9.6%和11%。基线时有非增殖性视网膜病变的患者发生增殖前期、PDR或黄斑病变的可能性是基线时无视网膜病变的患者的5倍（校正风险比5.0 [95% CI 4.4-5.6]）。在5-10年的随访中，在初始筛选检查时没有糖尿病视网膜病变的患者很少发展为增殖前视网膜病变、PDR或威胁视力的黄斑病变。筛查间隔时间超过一年可能适用于此类患者。
To estimate the incidence of diabetic retinopathy in relation to retinopathy grade at first examination and other prognostic characteristics. This was a dynamic cohort study of 20,686 people with type 2 diabetes who had annual retinal photography up to 14 times between 1990 and 2006. Cumulative and annual incidence rates were estimated using life tables, and risk factors for progression were identified using Cox regression analysis. Of 20,686 patients without proliferative diabetic retinopathy (PDR) or sight-threatening maculopathy at their first retinal examination (baseline), 16,444 (79%) did not have retinopathy, 3,632 (18%) had nonproliferative retinopathy, and 610 (2.9%) had preproliferative retinopathy. After 5 years, few patients without retinopathy at baseline developed preproliferative retinopathy (cumulative incidence 4.0%), sight-threatening maculopathy (0.59%), or PDR (0.68%); after 10 years, the respective cumulative incidences were 16.4, 1.2, and 1.5%. Among those with nonproliferative (background) retinopathy at baseline, after 1 year 23% developed preproliferative retinopathy, 5.2% developed maculopathy, and 6.1% developed PDR; after 10 years, the respective cumulative incidences were 53, 9.6, and 11%. Patients with nonproliferative retinopathy at baseline were five times more likely to develop preproliferative, PDR, or maculopathy than those without retinopathy at baseline (adjusted hazard ratio 5.0 [95% CI 4.4–5.6]). Few patients without diabetic retinopathy at the initial screening examination developed preproliferative retinopathy, PDR, or sight-threatening maculopathy after 5–10 years of follow-up. Screening intervals longer than a year may be appropriate for such patients.
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影响因子：
3.5
作者：
Harding, S;Greenwood, R;Leese, G
通讯作者：
Leese, G
影响因子：
8.2
作者：
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Matthews, DR
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1.7
作者：
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影响因子：
2.9
作者：
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Scanlon, P. H.
影响因子：
3.5
作者：
Misra, A.;Bachmann, M. O.;Jones, C. D.
通讯作者：
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