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Diabetic retinopathy in type 1 diabetes patients in Western Norway
Author(s) -
Jansson Ragnhild W.,
Hufthammer Karl Ove,
Krohn Jørgen
Publication year - 2018
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/aos.13654
Subject(s) - medicine , diabetes mellitus , diabetic retinopathy , fundus photography , retinopathy , cohort , population , type 2 diabetes , type 1 diabetes , ophthalmology , visual acuity , endocrinology , fluorescein angiography , environmental health
Purpose To describe the prevalence of diabetic retinopathy ( DR ), associated risk factors and health‐related quality of life ( HRQ oL) in a population‐based cohort of patients with type 1 diabetes mellitus ( DM 1). Methods All patients underwent a general and ophthalmic examination including seven‐field stereo fundus photography for grading of DR and diabetic macular oedema ( DMO ). Kaplan‐Meier survival analyses were performed to evaluate disease progression in relation to diabetes duration, age and year of diabetes onset. HRQ oL and its association with DR were assessed by the Medical Outcomes Study Short Form 36 ( SF ‐36) questionnaire. Results A total of 237 DM 1 patients were included. Mean age at inclusion was 34 years (range, 4–75 years), and mean diabetes duration was 19 years (range, 5 months–63 years). A total of 145 patients (61%) had DR . Sixty‐two patients (26%) had mild, 39 (16%) moderate and 13 (5%) severe nonproliferative DR , while 31 (13%) had proliferative DR . The prevalence of DMO was 8%. The most important risk factors predicting severity of DR were diabetes duration (p < 0.0001) and HbA1c level (p < 0.0001). Neuropathy (p = 0.006), nephropathy (p = 0.004) and male gender (p = 0.02) were also significant predictors of DR . Compared to normative SF ‐36 data, there was a linear trend of decreasing HRQ oL with increasing severity of DR that was statistically significant for the four physical dimension scores. Conclusion The prevalence of DR in DM 1 was largely within the range of previous reports. Diabetes duration, HbA1c level, neuropathy, nephropathy and male gender were all significant predictors of DR severity. The patients with more severe DR had lower HRQ oL.