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Prevalence of referable, sight-threatening retinopathy in type 1 diabetes and its relationship to diabetes duration and systemic risk factors

Prevalence of referable, sight-threatening retinopathy in type 1 diabetes and its relationship to diabetes duration and systemic risk factors
Prevalence of referable, sight-threatening retinopathy in type 1 diabetes and its relationship to diabetes duration and systemic risk factors

Purpose: The purpose of the study was to provide contemporary estimates for diabetic retinopathy (DR) prevalence in a well-defined UK cohort of patients with type 1 diabetes (T1DM) and investigate potential risk factors for proliferative diabetic retinopathy (PDR) and diabetic maculopathy.

Patients and Methods: Four hundred and sixty four T1DM patients in North Hampshire had T1DM duration, demographic and systemic risk factor data evaluated retrospectively alongside their DR status in 2010 using logistic regression analysis.

Results: Overall prevalence of any retinopathy, PDR, and maculopathy was 71.5%, 6.5%, and 10.8%, respectively. PDR and maculopathy prevalence were 0 and 0.7% for <10 years T1DM duration. PDR prevalence was 4%, 8%, and 16% for 10–19.9 years, 20–29.9, years and ≥30 years duration, respectively. Maculopathy prevalence was 15.6%, 18%, and 11% for 10–19.9 years, 20–29.9 years, and ≥30 years duration, respectively. In univariate analysis, PDR was associated with T1DM duration (odds ratio (OR) 1.07/year), age (OR 1.03/year), systolic blood pressure (OR 1.03/mmHg), and antihypertensive therapy (OR 10.63), while maculopathy was associated with duration (OR 1.03/year) and statin therapy (OR 2.83). In multivariate analysis, disease duration (OR 1.07/year) and antihypertensive therapy (OR 6.87) remained significantly associated with PDR, and maculopathy with statin therapy (OR 2.27).

Conclusion:This study confirms T1DM duration is a strong risk factor for sight-threatening DR. Maculopathy and PDR prevalence within 10 years of T1DM diagnosis is very low. PDR prevalence at 10–20 years was 4% and then doubled for every 10-year interval thereafter up to 16% with ≥30 years duration. Antihypertensive therapy and statin therapy were strongly associated with PDR and maculopathy, respectively.

0950-222X
333-341
Warwick, Alasdair
1bd025ef-2534-4351-bc4d-7df20d947e2d
A.P, Brooks
703044bd-da98-456e-9432-51715c7a91a3
Osmond, Clive
2677bf85-494f-4a78-adf8-580e1b8acb81
Krishnan, Radhika
b565120e-fead-456d-9f5d-35bbefd82c71
Warwick, Alasdair
1bd025ef-2534-4351-bc4d-7df20d947e2d
A.P, Brooks
703044bd-da98-456e-9432-51715c7a91a3
Osmond, Clive
2677bf85-494f-4a78-adf8-580e1b8acb81
Krishnan, Radhika
b565120e-fead-456d-9f5d-35bbefd82c71

Warwick, Alasdair, A.P, Brooks, Osmond, Clive and Krishnan, Radhika (2017) Prevalence of referable, sight-threatening retinopathy in type 1 diabetes and its relationship to diabetes duration and systemic risk factors. Eye, 31, 333-341. (doi:10.1038/eye.2016.294).

Record type: Article

Abstract

Purpose: The purpose of the study was to provide contemporary estimates for diabetic retinopathy (DR) prevalence in a well-defined UK cohort of patients with type 1 diabetes (T1DM) and investigate potential risk factors for proliferative diabetic retinopathy (PDR) and diabetic maculopathy.

Patients and Methods: Four hundred and sixty four T1DM patients in North Hampshire had T1DM duration, demographic and systemic risk factor data evaluated retrospectively alongside their DR status in 2010 using logistic regression analysis.

Results: Overall prevalence of any retinopathy, PDR, and maculopathy was 71.5%, 6.5%, and 10.8%, respectively. PDR and maculopathy prevalence were 0 and 0.7% for <10 years T1DM duration. PDR prevalence was 4%, 8%, and 16% for 10–19.9 years, 20–29.9, years and ≥30 years duration, respectively. Maculopathy prevalence was 15.6%, 18%, and 11% for 10–19.9 years, 20–29.9 years, and ≥30 years duration, respectively. In univariate analysis, PDR was associated with T1DM duration (odds ratio (OR) 1.07/year), age (OR 1.03/year), systolic blood pressure (OR 1.03/mmHg), and antihypertensive therapy (OR 10.63), while maculopathy was associated with duration (OR 1.03/year) and statin therapy (OR 2.83). In multivariate analysis, disease duration (OR 1.07/year) and antihypertensive therapy (OR 6.87) remained significantly associated with PDR, and maculopathy with statin therapy (OR 2.27).

Conclusion:This study confirms T1DM duration is a strong risk factor for sight-threatening DR. Maculopathy and PDR prevalence within 10 years of T1DM diagnosis is very low. PDR prevalence at 10–20 years was 4% and then doubled for every 10-year interval thereafter up to 16% with ≥30 years duration. Antihypertensive therapy and statin therapy were strongly associated with PDR and maculopathy, respectively.

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Final CLEAN- RK -230916 Prevalence of Diabetic Retinopathy in Type 1 Diabetes - Accepted Manuscript
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Accepted/In Press date: 20 January 2017
e-pub ahead of print date: 27 January 2017
Published date: February 2017
Organisations: Medical Research Council

Identifiers

Local EPrints ID: 406217
URI: http://eprints.soton.ac.uk/id/eprint/406217
ISSN: 0950-222X
PURE UUID: d24356b6-6430-4f8b-89b1-e25c166d3f68
ORCID for Clive Osmond: ORCID iD orcid.org/0000-0002-9054-4655

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Date deposited: 10 Mar 2017 10:42
Last modified: 16 Mar 2024 05:05

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Contributors

Author: Alasdair Warwick
Author: Brooks A.P
Author: Clive Osmond ORCID iD
Author: Radhika Krishnan

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