NEW YORK (Reuters Health) – Patients with type 2 diabetes who don’t have retinopathy at baseline have a relatively low risk of developing eye complications during 5 to 10 years of follow-up, according to a population-based UK study.
“Screening intervals longer than a year may be appropriate for such patients,” suggest the authors of the report in Diabetes Care online January 25.
Dr. Max O. Bachmann, with the Norwich Medical School at the University of East Anglia, and colleagues examined the incidence of retinopathy and progression rates in 20,686 people with diabetes who underwent annual retinal screening up to 14 times and who were initially free of proliferative diabetic retinopathy or sight-threatening maculopathy.
At their first examination, 79% of the cohort did not have retinopathy, 18% had non-proliferative retinopathy, and 3% had pre-proliferative retinopathy, the team found.
Among subjects initially free of retinopathy, the cumulative incidence of pre-proliferative retinopathy at 5 years was 4%; rates of sight-threatening maculopathy and proliferative diabetic retinopathy were 0.59% and 0.685, respectively, the report indicates. Corresponding rates at 10 years were 16.4%, 1.2% and 1.5%.
Risk of progression was higher for patients with non-proliferative retinopathy at baseline. At 1 year, 23% developed pre-proliferative retinopathy, 5.2% developed maculopathy, and 6.1% developed proliferative diabetic retinopathy, and at 10 years the corresponding rates were 53%, 9.6%, and 11%, Dr. Bachmann and colleagues report.
“In summary, this study provides further evidence in support of increasing diabetic retinopathy screening intervals to more than a year in patients without retinopathy at the time of their first retinal examination,” they conclude. “These findings should be evaluated with a randomized trial.”
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