Klein R, Klein B E, Moss S E, Cruickshanks K J
Department of Ophthalmology and Visual Sciences, University of Wisconsin Medical School, Madison.
Arch Ophthalmol. 1994 Sep;112(9):1217-28. doi: 10.1001/archopht.1994.01090210105023.
To examine the 10-year incidence and progression of diabetic retinopathy.
Population-based incidence study.
Seven hundred sixty-five insulin-taking diabetic persons diagnosed before age 30 years, 251 insulin-taking diabetic persons diagnosed at age 30 years or older, and 282 non-insulin-taking diabetic persons diagnosed at age 30 years or older who participated in baseline, 4-year, and 10-year follow-up examinations.
The 10-year incidence of any retinopathy, progression of retinopathy, and progression to proliferative retinopathy were detected by masked grading of stereoscopic color fundus photographs using the modified Airlie House classification and the Early Treatment Diabetic Retinopathy Study severity scheme.
The 10-year incidence of retinopathy (89%, 79%, and 67%), progression of retinopathy (76%, 69%, and 53%), and progression to proliferative retinopathy (30%, 24%, and 10%) were highest in the group diagnosed before age 30 years, intermediate in the insulin-taking group diagnosed at age 30 years or older, and lowest in the non-insulin-taking group, respectively. Increased risk of proliferative retinopathy was associated with more severe retinopathy at baseline.
These data suggest relatively high 10-year rates of incidence and progression of retinopathy, and despite changes in the treatment of diabetes, there has been little change in the incidence and progression of diabetic retinopathy during the 10-year study period.
研究糖尿病视网膜病变的10年发病率及病情进展情况。
基于人群的发病率研究。
765名30岁之前被诊断出的胰岛素依赖型糖尿病患者、251名30岁及以上被诊断出的胰岛素依赖型糖尿病患者以及282名30岁及以上被诊断出的非胰岛素依赖型糖尿病患者，这些患者均参与了基线、4年及10年的随访检查。
采用改良的艾利屋分类法和糖尿病视网膜病变早期治疗研究严重程度分级方案，通过对立体彩色眼底照片进行盲法分级，检测任何视网膜病变的10年发病率、视网膜病变的进展情况以及进展为增殖性视网膜病变的情况。
视网膜病变的10年发病率（89%、79%和67%）、视网膜病变的进展情况（76%、69%和53%）以及进展为增殖性视网膜病变的比例（30%、24%和10%）在30岁之前被诊断出的患者组中最高，在30岁及以上被诊断出的胰岛素依赖型患者组中处于中间水平，在非胰岛素依赖型患者组中最低。增殖性视网膜病变风险的增加与基线时更严重的视网膜病变相关。
这些数据表明视网膜病变的10年发病率和进展率相对较高，并且尽管糖尿病治疗方法有所改变，但在10年研究期间糖尿病视网膜病变的发病率和进展情况几乎没有变化。
