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Development and Progression of Diabetic Retinopathy: Adolescents at Risk
Author(s) -
Bonney M.,
Hing S.J.,
Fung A.T.W.,
Stephens M.M.,
Fairchild J.M.,
Donaghue K.C.,
Howard N.J.,
Silink M.
Publication year - 1995
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/j.1464-5491.1995.tb00407.x
Subject(s) - medicine , retinopathy , diabetic retinopathy , diabetes mellitus , fundus photography , fundus (uterus) , ophthalmology , endocrinology , visual acuity , fluorescein angiography
The aims of this study were to evaluate short‐term changes in retinopathy in adolescents, and to examine the relationship of these changes to risk factors. Two‐hundred and three adolescents, with a median age of 14.5 (range 10.4 to 20.6) yr and a median duration of diabetes of 6.6 (1.1 to 16.3) yr, were included in the study. Retinopathy was assessed on two occasions, using stereoscopic fundus photography; the median time between assessment was 1.3 (0.5 to 3.0) yr. At baseline, 41 % of the adolescents had background retinopathy. When patients were stratified according to the median diabetes duration (DD) (6.6 yr) and glycaemic control over the 12 months prior to assessment (HbA 1c ) (8.4 %), the percentage of retinopathy in each group was: lowDD/lowHbA 1c 13 %; lowDD/highHbA 1c 40 %; highDD/lowHbA 1c 42 %; and highDD/highHbA 1c 72 %. Using a 2‐step criteria for stability or change in retinopathy, 11 % of the 203 adolescents showed progression of retinopathy, 41 % had stable retinopathy, 5 % showed regression, and 43 % had no retinopathy at either assessment. Change in retinopathy was related to age at baseline assessment (borderline significance, p = 0.06), diabetes duration ( p < 0.001), glycaemic control ( p < 0.001) and total cholesterol ( p = 0.04), and was also related to DD/HbA 1c group membership ( X 2 p < 0.001). This study highlights the combined adverse effect of long diabetes duration and poor glycaemic control on the development and progression of retinopathy during adolescence, and identifies a group that is likely to show progression over a relatively short period.