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JR Gudmundsson, JK Kristinsson, E Stefansson; Systematic Screening for Diabetic Eye Disease 25 Year Experience in Iceland . Invest. Ophthalmol. Vis. Sci. 2002;43(13):4385.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: A screening program for diabetic eye disease was established in Iceland 25 years ago. We study the prevalence of diabetic retinopathy (DR) and evaluate visual acuity in the diabetic population involved in the screening program. Methods: We reviewed charts of all diabetic patients in the university eye clinic, a total of 1433 patients. 368 patients had type 1 diabetes (using insulin and age at onset <30 years), 213 (58%) males and 155 (42%) females. The median age of diagnosis was 16 (1-29) years and average duration of diabetes 20 (1-55) years. A total of 1065 patients had type 2 diabetes, 656 (62%) males and 459 (38%) females. The median age of diagnosis was 54 (30-84) years and average duration of diabetes 12 (1-40) years. Results: In the type 1 group, 49% had any DR and 13% proliferative diabetic retinopathy (PDR) and 3% history of diabetic macular edema (DME). In patients with less than 20 years of diabetes, 32% had any DR , 4% PDR and 3% history of DME. In patients with duration of 20 years or more, 75% had any DR, 26% PDR and 4% history of DME. 81% had visual acuity 6/6 or better, 1% legally blind (<6/60) and 2% partially sighted (<6/18, ≷6/60 ). In the type 2 group, 42% had any DR, 4% PDR and 7% history of DME. In patients with duration less than 20 years, 40% had any DR, 3% PDR and 6% history of DME. In patients with duration of 20 years or more, 59% had any DR, 7% PDR and 12% history of DME. 59% had 6/6 or better, 1% legally blind and 3% partially sighted. Conclusion: Diabetics who participate in regular screening program in Iceland have a low prevalence of blindness and partial sight. The current prevalence of retinopathy and blindness is similar to that seen in 1994, whereas blindness is much lower now than in 1980. This suggests that legal blindness rates have levelled out at about 1% and partial sight at about 3% in diabetics in regular screening programs.
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