Epidemiology of moderately severe and severe non-proliferative diabetic retinopathy in South West England

Nevill, Clareece R., Stratton, Irene M., Maruti, Sonia S., Massó-González, Elvira L., Sivaprasad, Sobha, Bailey, Clare, Ehrlich, Michael, Chong, Victor and Scanlon, Peter H ORCID: 0000-0001-8513-710X (2022) Epidemiology of moderately severe and severe non-proliferative diabetic retinopathy in South West England. Eye, 36 (2). pp. 433-440. doi:10.1038/s41433-021-01471-8

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Aims To estimate the incidence of early treatment diabetic retinopathy study (ETDRS) level 47 and 53 and progression to treatment with panretinal photocoagulation (PRP) for proliferative DR (PDR). Methods Log-linear regression was used to estimate the incidence of level 47-53 or worse for 33,009 people with diabetes (PWD) in Gloucestershire during 2013-2016 by calendar year and diabetes type, based on the first recording. Progression was analysed in Gloucestershire and Bristol with a parametric survival analysis examining the association of baseline and time-varying demographic and clinical factors on time to PRP after the first recording of level 47-53. Results Incidence decreased from 0.57 (95% confidence intervals (CI) 0.48-0.67) per 100 PWD in 2013 to 0.35 (95% CI 0.29-0.43) in 2016 (p < 0.001). For progression, 338 eligible PWD from Gloucestershire and 418 from Bristol were followed for a median of 1.4 years; 78 and 83% had Type 2 diabetes and a median (interquartile range) of 15 (10-22) and 17 (11-25) years duration of diagnosed diabetes respectively. Three years from the incident ETDRS 47-53, 18.9% and 17.2% had received PRP respectively. For Gloucestershire, severe IRMA and updated mean HbA(1c) were associated with an increase in the risk of initiating PRP (hazard ratio 3.14 (95% CI: 1.60-6.15) and 1.21 (95% CI: 1.06-1.38 per 10 mmol/mol) respectively). Conclusion This study provides additional understanding of this population and shows that a high proportion of patients with ETDRS levels 47-53 need to be monitored as they are at high risk of progressing to PDR.

Item Type: Article
Article Type: Article
Uncontrolled Keywords: Ophthalmology; Screening
Subjects: R Medicine > RA Public aspects of medicine > RA645.A-Z Individual diseases or groups of diseases, A-Z > RA645.D54 Diabetes
R Medicine > RE Ophthalmology
R Medicine > RZ Other systems of medicine
Research Priority Areas: Health, Life Sciences, Sport and Wellbeing
Depositing User: Susan Turner
Date Deposited: 01 Apr 2021 09:53
Last Modified: 15 Feb 2022 12:00
URI: https://eprints.glos.ac.uk/id/eprint/9536

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