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Epidemiology of moderately severe and severe non-proliferative diabetic retinopathy in South West England

Epidemiology of moderately severe and severe non-proliferative diabetic retinopathy in South West England
Epidemiology of moderately severe and severe non-proliferative diabetic retinopathy in South West England

Aims: to estimate the incidence of early treatment diabetic retinopathy study (ETDRS) level 47 and 53 and progression to treatment with panretinal photocoagulation (PRP) for proliferative DR (PDR). 

Methods: log-linear regression was used to estimate the incidence of level 47–53 or worse for 33,009 people with diabetes (PWD) in Gloucestershire during 2013–2016 by calendar year and diabetes type, based on the first recording. Progression was analysed in Gloucestershire and Bristol with a parametric survival analysis examining the association of baseline and time-varying demographic and clinical factors on time to PRP after the first recording of level 47–53. 

Results: incidence decreased from 0.57 (95% confidence intervals (CI) 0.48–0.67) per 100 PWD in 2013 to 0.35 (95% CI 0.29–0.43) in 2016 (p < 0.001). For progression, 338 eligible PWD from Gloucestershire and 418 from Bristol were followed for a median of 1.4 years; 78 and 83% had Type 2 diabetes and a median (interquartile range) of 15 (10–22) and 17 (11–25) years duration of diagnosed diabetes respectively. Three years from the incident ETDRS 47–53, 18.9% and 17.2% had received PRP respectively. For Gloucestershire, severe IRMA and updated mean HbA1c were associated with an increase in the risk of initiating PRP (hazard ratio 3.14 (95% CI: 1.60–6.15) and 1.21 (95% CI: 1.06–1.38 per 10 mmol/mol) respectively). 

Conclusion: this study provides additional understanding of this population and shows that a high proportion of patients with ETDRS levels 47–53 need to be monitored as they are at high risk of progressing to PDR.

0950-222X
433-440
Nevill, Clareece R.
c1ea5279-40f7-4525-8294-bd923b8bb7f3
Stratton, Irene M.
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Maruti, Sonia S.
1e4ac8f6-4678-4b59-ae84-0225d0e6a274
Massó-González, Elvira L.
881530ca-5ce1-4726-a51c-1afcdc63a785
Sivaprasad, Sobha
6ae3de79-66b3-4fc5-a91d-7de5f5887038
Bailey, Clare
f86729be-c141-4085-8acf-ef90a889e5a4
Ehrlich, Michael
249aa71e-fe57-4777-a5c0-f17fc57c87a2
Chong, Victor
796050a0-3992-4e80-a5d5-3f289a1e2758
Scanlon, Peter H.
4e3d2310-c79e-42db-ae29-7a7d6b278aa3
Nevill, Clareece R.
c1ea5279-40f7-4525-8294-bd923b8bb7f3
Stratton, Irene M.
772f25b9-23c0-4240-a3f6-1e76b03b172f
Maruti, Sonia S.
1e4ac8f6-4678-4b59-ae84-0225d0e6a274
Massó-González, Elvira L.
881530ca-5ce1-4726-a51c-1afcdc63a785
Sivaprasad, Sobha
6ae3de79-66b3-4fc5-a91d-7de5f5887038
Bailey, Clare
f86729be-c141-4085-8acf-ef90a889e5a4
Ehrlich, Michael
249aa71e-fe57-4777-a5c0-f17fc57c87a2
Chong, Victor
796050a0-3992-4e80-a5d5-3f289a1e2758
Scanlon, Peter H.
4e3d2310-c79e-42db-ae29-7a7d6b278aa3

Nevill, Clareece R., Stratton, Irene M., Maruti, Sonia S., Massó-González, Elvira L., Sivaprasad, Sobha, Bailey, Clare, Ehrlich, Michael, Chong, Victor and Scanlon, Peter H. (2021) Epidemiology of moderately severe and severe non-proliferative diabetic retinopathy in South West England. Eye (Basingstoke), 36 (2), 433-440. (doi:10.1038/s41433-021-01471-8).

Record type: Article

Abstract

Aims: to estimate the incidence of early treatment diabetic retinopathy study (ETDRS) level 47 and 53 and progression to treatment with panretinal photocoagulation (PRP) for proliferative DR (PDR). 

Methods: log-linear regression was used to estimate the incidence of level 47–53 or worse for 33,009 people with diabetes (PWD) in Gloucestershire during 2013–2016 by calendar year and diabetes type, based on the first recording. Progression was analysed in Gloucestershire and Bristol with a parametric survival analysis examining the association of baseline and time-varying demographic and clinical factors on time to PRP after the first recording of level 47–53. 

Results: incidence decreased from 0.57 (95% confidence intervals (CI) 0.48–0.67) per 100 PWD in 2013 to 0.35 (95% CI 0.29–0.43) in 2016 (p < 0.001). For progression, 338 eligible PWD from Gloucestershire and 418 from Bristol were followed for a median of 1.4 years; 78 and 83% had Type 2 diabetes and a median (interquartile range) of 15 (10–22) and 17 (11–25) years duration of diagnosed diabetes respectively. Three years from the incident ETDRS 47–53, 18.9% and 17.2% had received PRP respectively. For Gloucestershire, severe IRMA and updated mean HbA1c were associated with an increase in the risk of initiating PRP (hazard ratio 3.14 (95% CI: 1.60–6.15) and 1.21 (95% CI: 1.06–1.38 per 10 mmol/mol) respectively). 

Conclusion: this study provides additional understanding of this population and shows that a high proportion of patients with ETDRS levels 47–53 need to be monitored as they are at high risk of progressing to PDR.

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Accepted/In Press date: 15 February 2021
Published date: 10 March 2021

Identifiers

Local EPrints ID: 487210
URI: http://eprints.soton.ac.uk/id/eprint/487210
ISSN: 0950-222X
PURE UUID: 3a824aa5-5cb5-466d-a4d9-62ae875ee6ef
ORCID for Irene M. Stratton: ORCID iD orcid.org/0000-0003-1172-7865

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Date deposited: 16 Feb 2024 10:31
Last modified: 18 Mar 2024 04:01

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Contributors

Author: Clareece R. Nevill
Author: Irene M. Stratton ORCID iD
Author: Sonia S. Maruti
Author: Elvira L. Massó-González
Author: Sobha Sivaprasad
Author: Clare Bailey
Author: Michael Ehrlich
Author: Victor Chong
Author: Peter H. Scanlon

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