Department of Ophthalmology, Duke University Eye Center, Durham, North Carolina, USA.
Retina. 2013 May;33(5):911-9. doi: 10.1097/IAE.0b013e3182831248.
To compare the longitudinal incidence over 10 years of dry and wet age-related macular degeneration (AMD) in a U.S. sample of Medicare beneficiaries with no diabetes mellitus, diabetes mellitus without retinopathy, nonproliferative diabetic retinopathy (NPDR), and proliferative diabetic retinopathy (PDR).
Using Medicare claims data, the 10-year incidence of dry and wet AMD from 1995 to 2005 in beneficiaries older than 69 years with newly diagnosed diabetes mellitus (n = 6,621), NPDR (n = 1,307), and PDR (n = 327) compared with each other and matched controls without diabetes for each group.
After controlling for covariates, newly diagnosed NPDR was associated with significantly increased risk of incident diagnosis of dry AMD (hazard ratio, 1.24; 95% confidence interval: 1.08-1.43) and wet AMD (hazard ratio 1.68; 95% confidence interval: 1.23-2.31). Newly diagnosed PDR was associated with significantly increased risk of wet AMD only (hazard ratio 2.15; 95% confidence interval: 1.07-4.33). Diabetes without retinopathy did not affect risk of dry or wet AMD. There was no difference in risk of wet AMD in PDR compared with NPDR.
Elderly individuals with NPDR or PDR may be at higher risk of AMD compared to those without diabetes mellitus or diabetic retinopathy.
比较 10 年内美国无糖尿病、无糖尿病视网膜病变、非增殖性糖尿病视网膜病变和增殖性糖尿病视网膜病变的医疗保险受益人群干性和湿性年龄相关性黄斑变性（AMD）的纵向发病率。
利用医疗保险索赔数据，对 1995 年至 2005 年期间年龄在 69 岁以上、新诊断为糖尿病（n=6621）、非增殖性糖尿病视网膜病变（n=1307）和增殖性糖尿病视网膜病变（n=327）的受益人的干性和湿性 AMD 的 10 年发病率进行了比较，并与每个组的无糖尿病对照组进行了比较。
在控制了协变量后，新诊断的 NPDR 与干性 AMD（风险比，1.24；95%置信区间：1.08-1.43）和湿性 AMD（风险比 1.68；95%置信区间：1.23-2.31）的新发诊断显著相关。新诊断的 PDR 仅与湿性 AMD 的风险显著相关（风险比 2.15；95%置信区间：1.07-4.33）。无视网膜病变的糖尿病并不影响干性或湿性 AMD 的风险。PDR 与 NPDR 相比，湿性 AMD 的风险无差异。
与无糖尿病或糖尿病视网膜病变的患者相比，患有 NPDR 或 PDR 的老年患者可能更容易患 AMD。
