Four-Year Screening Interval and Vision-Threatening Retinopathy in Type 2 Diabetes Patients With Good Glycemic Control.

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  • Author(s): Tsujimoto T;Tsujimoto T;Tsujimoto T; Kajio H; Kajio H
  • Source:
    Mayo Clinic proceedings [Mayo Clin Proc] 2021 Feb; Vol. 96 (2), pp. 322-331.
  • Publication Type:
    Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't
  • Language:
    English
  • Additional Information
    • Source:
      Publisher: [Oxford, England] Country of Publication: England NLM ID: 0405543 Publication Model: Print Cited Medium: Internet ISSN: 1942-5546 (Electronic) Linking ISSN: 00256196 NLM ISO Abbreviation: Mayo Clin Proc Subsets: MEDLINE
    • Publication Information:
      Publication: Jan. 2012- : [Oxford, England] : Elsevier
      Original Publication: Rochester, MN : Mayo Foundation for Medical Education and Research
    • Subject Terms:
      Diabetes Mellitus, Type 2* ; Glycemic Control*; Diabetic Retinopathy/*epidemiology ; Mass Screening/*statistics & numerical data; Adult ; Aged ; Canada/epidemiology ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Risk Factors ; United States/epidemiology
    • Abstract:
      Objective: To assess whether vision-threatening retinopathy developed after 4 years in patients with type 2 diabetes with good glycemic control during follow-up.
      Patients and Methods: Using data from the Action to Control Cardiovascular Risk in Diabetes and Action to Control Cardiovascular Risk in Diabetes Follow-on studies (conducted from January 1, 2001, to October 14, 2014), we investigated the incidence of vision-threatening retinopathy after 4 years in patients with type 2 diabetes with good or poor glycemic control. Patients with proliferative diabetic retinopathy at baseline were excluded. Vision-threatening retinopathy was defined as severe nonproliferative diabetic retinopathy, proliferative diabetic retinopathy, laser photocoagulation, or vitrectomy. Good and poor glycemic control was defined as mean glycated hemoglobin level less than 7% and 7% or greater during follow-up, respectively.
      Results: This study included 2285 patients. Among patients with no retinopathy at baseline, the 4-year incidence of vision-threatening retinopathy was 0% (0 of 386) and 0.8% (6 of 721) in those with good and poor glycemic control, respectively (P=.54). Similarly, severe retinopathy was not observed at 8 years in patients who did not have retinopathy at 4 years. Among patients with mild to moderate nonproliferative diabetic retinopathy at baseline, the 4-year incidence of vision-threatening retinopathy was significantly higher in those with poor glycemic control than in those with good glycemic control (9.7% [77 of 790] vs 4.4% [13 of 297]; P=.004). Additionally, the remission rate of diabetic retinopathy was low in patients with a long duration of diabetes. Four-year incidences of vision-threatening retinopathy were higher in patients with retinopathy at baseline who had poorer glycemic control and longer durations of diabetes.
      Conclusion: It may be safe to extend screening intervals for diabetic retinopathy to 4 years or longer in patients with type 2 diabetes with no retinopathy.
      (Copyright © 2020 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.)
    • Comments:
      Comment in: Mayo Clin Proc. 2021 Feb;96(2):282-284. (PMID: 33549248)
    • Publication Date:
      Date Created: 20210207 Date Completed: 20210309 Latest Revision: 20210309
    • Publication Date:
      20231215
    • Accession Number:
      10.1016/j.mayocp.2020.07.031
    • Accession Number:
      33549254