Waltman S R
Trans Am Ophthalmol Soc. 1984;82:827-49.
Fifty-nine patients with juvenile-onset, insulin-dependent diabetes mellitus were followed for 5 years with sequential retinal photographs and ocular fluorophotometry. Very good metabolic control with a mean hemoglobin A1C level of 8.8% was maintained with conventional twice daily insulin injections. The incidence of retinopathy during the initial 10 years of the disease was considerably lower than that in previously reported series. The incidence of the development of retinopathy within the first 5 to 7 years of diabetes was 0 compared to a previous predicted incidence of 44%. It was possible to separate patients with diabetes mellitus without visible retinopathy from a group of normal control subjects. In this group of patients high hemoglobin A1C levels and thickened capillary basement membranes were not predictive of the development of progression of retinopathy. High vitreous fluorescein values and simultaneously high aqueous and vitreous fluorescein values were indicative of the presence of retinopathy or were harbingers of the development or progression of retinopathy. Disease duration was the single most important factor in determining the prevalence of retinopathy.
对59例青少年起病的胰岛素依赖型糖尿病患者进行了为期5年的随访，期间定期拍摄视网膜照片并进行眼荧光光度测定。通过每日两次常规胰岛素注射，患者维持了非常良好的代谢控制，平均糖化血红蛋白A1C水平为8.8%。该疾病最初10年视网膜病变的发生率显著低于先前报道的系列研究。糖尿病发病后头5至7年内视网膜病变的发生率为0，而先前预测的发生率为44%。可以将无明显视网膜病变的糖尿病患者与一组正常对照受试者区分开来。在这组患者中，高糖化血红蛋白A1C水平和增厚的毛细血管基底膜并不能预测视网膜病变的发生或进展。高玻璃体荧光素值以及同时出现的高房水和玻璃体荧光素值表明存在视网膜病变，或是视网膜病变发生或进展的先兆。病程是决定视网膜病变患病率的唯一最重要因素。
