The United Kingdom Diabetic Retinopathy Electronic Medical Record Users Group: Report 3: Baseline Retinopathy and Clinical Features Predict Progression of Diabetic Retinopathy
| Autor: | Cecilia S. Lee, Aaron Y. Lee, Douglas Baughman, Dawn Sim, Toks Akelere, Christopher Brand, David P. Crabb, Alastair K. Denniston, Louise Downey, Alan Fitt, Rehna Khan, Sajad Mahmood, Kaveri Mandal, Martin Mckibbin, Geeta Menon, Aires Lobo, B. Vineeth Kumar, Salim Natha, Atul Varma, Elizabeth Wilkinson, Danny Mitry, Clare Bailey, Usha Chakravarthy, Adnan Tufail, Catherine Egan, Faruque Ghanchi, Jong Min Ong, Sajjad Mahmood, Quresh Mohamed, Saher Al-Husainy, Marin Mckibbin, Narendra Dhingra, Sumit Dhingra, Richard Antcliff, Vineeth Kumar |
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| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty Time Factors Visual acuity Databases Factual Visual Acuity Retinal Neovascularization Article Cohort Studies 03 medical and health sciences 0302 clinical medicine Risk Factors Ophthalmology Diabetes mellitus medicine Intraretinal microvascular abnormalities Electronic Health Records Humans 030212 general & internal medicine Aged Proportional Hazards Models Diabetic Retinopathy business.industry Hazard ratio Diabetic retinopathy Middle Aged medicine.disease United Kingdom eye diseases Vitreous Hemorrhage Surgery Vitreous hemorrhage Disease Progression 030221 ophthalmology & optometry RE Female sense organs medicine.symptom business RC Cohort study Retinopathy |
| Zdroj: | American Journal of Ophthalmology. 180:64-71 |
| ISSN: | 0002-9394 |
| DOI: | 10.1016/j.ajo.2017.05.020 |
| Popis: | Purpose\ud To determine the time and risk factors for developing proliferative diabetic retinopathy (PDR) and vitreous hemorrhage (VH).\ud \ud Design\ud Multicenter, national cohort study.\ud \ud Methods\ud Anonymized data of 50 254 patient eyes with diabetes mellitus at 19 UK hospital eye services were extracted at the initial and follow-up visits between 2007 and 2014. Time to progression of PDR and VH were calculated with Cox regression after stratifying by baseline diabetic retinopathy (DR) severity and adjusting for age, sex, race, and starting visual acuity.\ud \ud Results\ud Progression to PDR in 5 years differed by baseline DR: no DR (2.2%), mild (13.0%), moderate (27.2%), severe nonproliferative diabetic retinopathy (NPDR) (45.5%). Similarly, 5-year progression to VH varied by baseline DR: no DR (1.1%), mild (2.9%), moderate (7.3%), severe NPDR (9.8%). Compared with no DR, the patient eyes that presented with mild, moderate, and severe NPDR were 6.71, 14.80, and 28.19 times more likely to develop PDR, respectively. In comparison to no DR, the eyes with mild, moderate, and severe NPDR were 2.56, 5.60, and 7.29 times more likely to develop VH, respectively. In severe NPDR, the eyes with intraretinal microvascular abnormalities (IRMA) had a significantly increased hazard ratio (HR) of developing PDR (HR 1.77, 95% confidence interval [CI] 1.25–2.49, P = .0013) compared with those with venous beading, whereas those with 4-quadrant dot-blot hemorrhages (4Q DBH) had 3.84 higher HR of developing VH (95% CI 1.39–10.62, P = .0095).\ud \ud Conclusions\ud Baseline severities and features of initial DR are prognostic for PDR development. IRMA increases risk of PDR whereas 4Q DBH increases risk of VH. |
| Databáze: | OpenAIRE |
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