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Ocular factors in the incidence and progression of diabetic retinopathy.
Ophthalmology. 1994 Jan; 101(1):77-83.O

Abstract

PURPOSE

To investigate the association of intraocular pressure (IOP), ocular perfusion pressure, and myopia with the incidence and progression of diabetic retinopathy.

METHODS

The design is a cohort study of a population-based sample (n = 1210) of persons with younger-onset diabetes (diagnosis was made before 30 years of age, and subjects were taking insulin) and a random sample (n = 1780) of persons with older-onset diabetes (diagnosis made after 30 years of age). Baseline and 4-year follow-up examinations were completed by 891 younger-onset and 987 older-onset persons. Retinopathy was graded from stereoscopic fundus photographs. Endpoints were incidence of retinopathy, progression of retinopathy, and progression to proliferative diabetic retinopathy (PDR). Ocular perfusion pressure was calculated from IOP and blood pressure. Myopia was a refractive error of -2 diopters or less.

RESULTS

In univariate analyses, ocular perfusion pressure was associated with incidence of retinopathy (P < 0.005), progression of retinopathy (P = 0.07), and progression to PDR (P < 0.001) in the younger-onset group but not in older-onset subjects taking or not taking insulin. Intraocular pressure and myopia were not associated with any endpoint in any group. Using logistic regression to control for covariates, ocular perfusion pressure was significantly associated only with incidence of retinopathy in younger-onset persons. The odds ratio for a 10-mmHg increase in ocular perfusion pressure was 2.13 (95% confidence interval, 1.30-3.50). Also, myopia was protective for progression to PDR in younger-onset persons with an odds ratio of 0.40 (95% confidence interval, 0.18-0.86).

CONCLUSIONS

These results suggest that pressure phenomena may be related to the development of retinopathy in younger-onset persons. This would have implications for treatments affecting both IOP and blood pressure.

Authors+Show Affiliations

Department of Ophthalmology, University of Wisconsin Medical School, Madison.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

8302567

Citation

Moss, S E., et al. "Ocular Factors in the Incidence and Progression of Diabetic Retinopathy." Ophthalmology, vol. 101, no. 1, 1994, pp. 77-83.
Moss SE, Klein R, Klein BE. Ocular factors in the incidence and progression of diabetic retinopathy. Ophthalmology. 1994;101(1):77-83.
Moss, S. E., Klein, R., & Klein, B. E. (1994). Ocular factors in the incidence and progression of diabetic retinopathy. Ophthalmology, 101(1), 77-83.
Moss SE, Klein R, Klein BE. Ocular Factors in the Incidence and Progression of Diabetic Retinopathy. Ophthalmology. 1994;101(1):77-83. PubMed PMID: 8302567.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Ocular factors in the incidence and progression of diabetic retinopathy. AU - Moss,S E, AU - Klein,R, AU - Klein,B E, PY - 1994/1/1/pubmed PY - 1994/1/1/medline PY - 1994/1/1/entrez SP - 77 EP - 83 JF - Ophthalmology JO - Ophthalmology VL - 101 IS - 1 N2 - PURPOSE: To investigate the association of intraocular pressure (IOP), ocular perfusion pressure, and myopia with the incidence and progression of diabetic retinopathy. METHODS: The design is a cohort study of a population-based sample (n = 1210) of persons with younger-onset diabetes (diagnosis was made before 30 years of age, and subjects were taking insulin) and a random sample (n = 1780) of persons with older-onset diabetes (diagnosis made after 30 years of age). Baseline and 4-year follow-up examinations were completed by 891 younger-onset and 987 older-onset persons. Retinopathy was graded from stereoscopic fundus photographs. Endpoints were incidence of retinopathy, progression of retinopathy, and progression to proliferative diabetic retinopathy (PDR). Ocular perfusion pressure was calculated from IOP and blood pressure. Myopia was a refractive error of -2 diopters or less. RESULTS: In univariate analyses, ocular perfusion pressure was associated with incidence of retinopathy (P < 0.005), progression of retinopathy (P = 0.07), and progression to PDR (P < 0.001) in the younger-onset group but not in older-onset subjects taking or not taking insulin. Intraocular pressure and myopia were not associated with any endpoint in any group. Using logistic regression to control for covariates, ocular perfusion pressure was significantly associated only with incidence of retinopathy in younger-onset persons. The odds ratio for a 10-mmHg increase in ocular perfusion pressure was 2.13 (95% confidence interval, 1.30-3.50). Also, myopia was protective for progression to PDR in younger-onset persons with an odds ratio of 0.40 (95% confidence interval, 0.18-0.86). CONCLUSIONS: These results suggest that pressure phenomena may be related to the development of retinopathy in younger-onset persons. This would have implications for treatments affecting both IOP and blood pressure. SN - 0161-6420 UR - https://www.unboundmedicine.com/medline/citation/8302567/Ocular_factors_in_the_incidence_and_progression_of_diabetic_retinopathy_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0161-6420(94)31353-4 DB - PRIME DP - Unbound Medicine ER -