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M.L. Laursen, A. Green, M. Hansen, H. Beck–Nielsen, A.K. Sjoelie; Incidence of and Risk Factors for Diabetic Maculopathy in a Danish Photographic Screening Programme . Invest. Ophthalmol. Vis. Sci. 2005;46(13):393.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: Diabetic maculopathy is a frequent and feared complication to diabetes mellitus. Risk factors for this condition have been less intensively investigated previously. The aims were to evaluate the incidence of and risk factors for development of diabetic maculopathy in a clinic–based photo–graphic screening programme in the county of Funen, Denmark. Methods: A longitudinal observational study during 1997–2001, including 1218 patients (696 type 1 and 522 type 2 diabetic patients) without diabetic maculopathy in either eye at baseline. Screening was carried out by two–field non–stereoscopic photography in mydriasis. Results: Forty–seven type 1 diabetic patients and 39 patients with type 2 diabetes developed maculopathy during observation. The incidence rate for diabetic maculopathy was 25.4/1000 person–years (a 5–year incidence rate of 11.9%) and 31.8/1000 person–years (a 5–year incidence rate of 14.7%) in patients with type 1 and type 2 diabetes respectively. In a multivariate Poisson regression analysis including duration of diabetes, diastolic blood pressure, vibration perception threshold, HbA1c, urinary albumin excretion rate and triglyceride as variables, development of diabetic maculopathy was significantly associated with peripheral vibration perception threshold (the incidence rate ratio (IRR): 1.29, p<0.01) and HbA1c (IRR: 1.35, p<0.05) in patients with type 1 diabetes and duration of diabetes (IRR: 1.10, p<0.01) and increased urinary albumin excretion rate (IRR: 1.85, p<0.05) in type 2 diabetic patients. Conclusions: The incidence of diabetic maculopathy was not significantly different between patients with type 1 and type 2 diabetes mellitus in this clinic–based photographic screening clinic. Mixed sensory–autonomic polyneuropathy is the most common clinical subtype of diabetic neuropathy. The association found between DME and vibration perception threshold in patients with type 1 diabetes may reflect abnormalities in regulation of the choroidal blood flow in the eye, which is heavily innervated and regulated by the autonomic nervous system.
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