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V. Kalesnykiene, R. Voutilainen–Kaunisto, I. Sorri, L. Niskanen, H. Uusitalo; Association of Detailed Morphological Changes of Fundus in Diabetic Retinopathy With the Clinical and Biochemical Parameters: Ten–Year Follow–Up Study in Type 2 Diabetes . Invest. Ophthalmol. Vis. Sci. 2006;47(13):3834.
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© ARVO (1962-2015); The Authors (2016-present)
Diabetic retinopathy (DR) remains the most common cause of blindness in the working age population in developed countries. Microaneurysms, haemorrhagies, hard and soft exudates are pathological features of diabetic retinopathy. The aim of the present study was to analyse the changes of diabetic retinopathy by using a quantitative measures and investigate the association between the above mentioned pathological features of DR and the level of glycated haemoglobin A1c (HbA1c), urine proteins and diastolic blood pressure. In addition, the association between pathological hallmarks of DR and the age of patients was studied.
The original study population consisted of 133 patients with newly diagnosed type 2 diabetes mellitus aged 45 to 64 years. A study group of 77 participants was included in this investigation because of the availability of fundus photographs at baseline, 5 and 10 years. The collection of participants was carried out from a defined area of 180000 inhabitants in Kuopio, Eastern Finland. All patients were examined within four weeks after the detection of diabetes. Patients were followed–up for 10 years. The fundus photographs of participants were taken at the baseline, after 5 years and after 10 years. The digitized photographs were analyzed using Adobe Photoshop program (Adobe Systems Inc., USA). Pathological features such as microaneurysms and soft exudates were counted; the area of haemorrhages and hard exudates was measured. Clinical and biochemical data were also collected. The analyses of data were carried out using SPSS program (v11.5, SPSS Inc., USA).
The level of HbA1c at baseline and at 5 years of follow–up was significantly correlated with the number of microaneyrysms and the area of hard exudates mainly at 10 year examination. The level of HbA1c at 10 years of follow–up was significantly associated only with the total area of haemorrhages. Urine proteins, diastolic blood pressure and age did not have significant correlations with pathological parameters of the fundus photographs.
The level of HbA1c may serve as a prognostic factor for the progression of DR and was correlated with number of microaneurysms and area of hard exudates during the later course of the disease.
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