Gloucestershire Diabetic Retinopathy Research Group, Cheltenham General Hospital, Cheltenham, Gloucestershire, United Kingdom.
Diabetes Care. 2013 Mar;36(3):580-5. doi: 10.2337/dc12-0625. Epub 2012 Nov 12.
The American Diabetes Association and the English NHS Diabetic Eye Screening Program recommend annual screening for diabetic retinopathy (DR) with referral to ophthalmology clinics of patients with sight-threatening DR (STDR). Using only longitudinal data from retinal photographs in the population-based NHS Diabetic Eye Screening Program in Gloucestershire, we developed a simple means to estimate risk of STDR.
From 2005, 14,554 patients with no DR or mild nonproliferative DR only at two consecutive annual digital photographic screenings were categorized by the presence of DR in neither, one, or both eyes at each screening and were followed for a further median 2.8 years.
Of 7,246 with no DR at either screening, 120 progressed to STDR, equivalent to an annual rate of 0.7%. Of 1,778 with no DR in either eye at first screening and in one eye at second screening, 80 progressed to STDR, equivalent to an annual rate of 1.9% and to a hazard ratio (HR) of 2.9 (95% CI 2.2-3.8) compared with those with no DR. Of 1,159 with background DR in both eyes at both screenings, 299 progressed to STDR equivalent to an annual rate of 11% and an HR of 18.2 (14.7-22.5) compared with individuals with no DR.
Combining the results from 2 consecutive years of photographic screening enables estimation of the risk of future development of STDR. In countries with systematic screening programs, these results could inform decisions about screening frequency.
美国糖尿病协会和英国国民保健署糖尿病眼病筛查计划建议对糖尿病视网膜病变（DR）进行年度筛查，并将有威胁视力的 DR（STDR）患者转诊至眼科诊所。我们仅使用基于人群的格洛斯特郡国民保健署糖尿病眼病筛查计划中的视网膜照片的纵向数据，开发了一种简单的方法来估计 STDR 的风险。
自 2005 年以来，在连续两次数字摄影筛查中均无 DR 或仅轻度非增殖性 DR 的 14554 例患者，根据两次筛查中每只眼睛均无、一只或两只眼睛的 DR 存在情况进行分类，并进一步随访中位数为 2.8 年。
在两次筛查中均无 DR 的 7246 例患者中，有 120 例进展为 STDR，年发生率为 0.7%。在首次筛查中每只眼睛均无 DR 而在第二次筛查中仅一只眼睛有 DR 的 1778 例患者中，有 80 例进展为 STDR，年发生率为 1.9%，与无 DR 的患者相比，风险比（HR）为 2.9（95%CI 2.2-3.8）。在两次筛查中均有背景性 DR 的 1159 例患者中，有 299 例进展为 STDR，年发生率为 11%，与无 DR 的患者相比，HR 为 18.2（14.7-22.5）。
结合连续两年的摄影筛查结果，可以估计未来发展为 STDR 的风险。在有系统筛查计划的国家，这些结果可以为筛查频率的决策提供信息。
