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The 14-year incidence of visual loss in a diabetic population.
Ophthalmology 1998; 105(6):998-1003O

Abstract

OBJECTIVE

The purpose of the study was to estimate the 14-year incidence of visual loss in a diabetic population and to examine its relationship to potential risk factors.

DESIGN

Cohort study.

PARTICIPANTS

A population-based sample of younger onset diabetic persons diagnosed younger than 30 years of age and taking insulin (n = 880) were examined at baseline, 4 years, 10 years, and 14 years.

INTERVENTION

Visual acuity (VA) as measured by the Early Treatment Diabetic Retinopathy Study protocol was performed.

MAIN OUTCOME MEASURES

Visual impairment (VI), defined as a VA of 20/40 or worse in the better eye; blindness, defined as a VA of 20/200 or worse in the better eye; and doubling of the visual angle were measured.

RESULTS

Cumulative 14-year incidences of VI, doubling of the visual angle, and blindness were 12.7%, 14.2%, and 2.4%, respectively. In univariate analyses, loss of vision as measured by doubling of the visual angle is associated with older age, longer duration of diabetes, higher glycosylated hemoglobin, higher systolic and diastolic blood pressure, presence of proteinuria, more pack-years smoked, presence of macular edema, and more severe retinopathy. In logistic regression analyses, incidence of doubling of the visual angle is associated independently with retinopathy (odds ratio [OR], 1.07; 95% confidence interval [CI], 1.03, 1.11 for each level), glycosylated hemoglobin (OR, 1.46; 95% CI, 1.28, 1.66 for each 1%), proteinuria (OR, 2.32; 95% CI, 1.39, 3.88 for presence), and age (OR, 1.45; 95% CI, 1.20, 1.75 for 10 years). In addition, a change in glycosylated hemoglobin from baseline to the 4-year examination is associated with loss of vision (OR, 1.15; 95% CI, 1.02, 1.30 for a 1% increase).

CONCLUSIONS

Loss of vision continues to be significant in persons with diabetes. These results suggest that prevention of retinopathy through control of glycemia will have a beneficial effect on visual outcome.

Authors+Show Affiliations

Department of Ophthalmology and Visual Sciences, University of Wisconsin Medical School, Madison, USA.No affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

9627648

Citation

Moss, S E., et al. "The 14-year Incidence of Visual Loss in a Diabetic Population." Ophthalmology, vol. 105, no. 6, 1998, pp. 998-1003.
Moss SE, Klein R, Klein BE. The 14-year incidence of visual loss in a diabetic population. Ophthalmology. 1998;105(6):998-1003.
Moss, S. E., Klein, R., & Klein, B. E. (1998). The 14-year incidence of visual loss in a diabetic population. Ophthalmology, 105(6), pp. 998-1003.
Moss SE, Klein R, Klein BE. The 14-year Incidence of Visual Loss in a Diabetic Population. Ophthalmology. 1998;105(6):998-1003. PubMed PMID: 9627648.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The 14-year incidence of visual loss in a diabetic population. AU - Moss,S E, AU - Klein,R, AU - Klein,B E, PY - 1998/6/17/pubmed PY - 1998/6/17/medline PY - 1998/6/17/entrez SP - 998 EP - 1003 JF - Ophthalmology JO - Ophthalmology VL - 105 IS - 6 N2 - OBJECTIVE: The purpose of the study was to estimate the 14-year incidence of visual loss in a diabetic population and to examine its relationship to potential risk factors. DESIGN: Cohort study. PARTICIPANTS: A population-based sample of younger onset diabetic persons diagnosed younger than 30 years of age and taking insulin (n = 880) were examined at baseline, 4 years, 10 years, and 14 years. INTERVENTION: Visual acuity (VA) as measured by the Early Treatment Diabetic Retinopathy Study protocol was performed. MAIN OUTCOME MEASURES: Visual impairment (VI), defined as a VA of 20/40 or worse in the better eye; blindness, defined as a VA of 20/200 or worse in the better eye; and doubling of the visual angle were measured. RESULTS: Cumulative 14-year incidences of VI, doubling of the visual angle, and blindness were 12.7%, 14.2%, and 2.4%, respectively. In univariate analyses, loss of vision as measured by doubling of the visual angle is associated with older age, longer duration of diabetes, higher glycosylated hemoglobin, higher systolic and diastolic blood pressure, presence of proteinuria, more pack-years smoked, presence of macular edema, and more severe retinopathy. In logistic regression analyses, incidence of doubling of the visual angle is associated independently with retinopathy (odds ratio [OR], 1.07; 95% confidence interval [CI], 1.03, 1.11 for each level), glycosylated hemoglobin (OR, 1.46; 95% CI, 1.28, 1.66 for each 1%), proteinuria (OR, 2.32; 95% CI, 1.39, 3.88 for presence), and age (OR, 1.45; 95% CI, 1.20, 1.75 for 10 years). In addition, a change in glycosylated hemoglobin from baseline to the 4-year examination is associated with loss of vision (OR, 1.15; 95% CI, 1.02, 1.30 for a 1% increase). CONCLUSIONS: Loss of vision continues to be significant in persons with diabetes. These results suggest that prevention of retinopathy through control of glycemia will have a beneficial effect on visual outcome. SN - 0161-6420 UR - https://www.unboundmedicine.com/medline/citation/9627648/The_14_year_incidence_of_visual_loss_in_a_diabetic_population_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0161-6420(98)96025-0 DB - PRIME DP - Unbound Medicine ER -