Abstract
Purpose :
Despite effective treatment options, diabetic retinopathy (DR) remains a leading cause of vision loss. This study investigated factors associated with an increased risk of developing sustained blindness (SB) among eyes with newly diagnosed DR and good vision within the IRIS® Registry.
Methods :
IRIS records from January 1, 2013 to December 31, 2017 were reviewed to identify eyes with newly diagnosed DR that had ≥ 2 visual acuity (VA) readings of 20/40 or better before or up to 3 months post DR diagnosis (index date). An 18-month look-back period was used to confirm no prior DR or other history of retinal conditions or treatments. Among these eyes, those that developed SB (defined as ≥ 2 VA readings of 20/200 or worse ≥ 3 months apart) were identified. Patients were followed from index to development of SB (event) or most recent VA reading (censored). Kaplan-Meier curves assessing time to SB by DR status and multivariable Cox proportional hazards regression modeling adjusting for baseline characteristics and time-varying ocular conditions developed during follow-up on risk of SB were performed.
Results :
A total of 53,535 eyes meeting the prespecified DR and VA criteria were identified. DR severity distribution among these eyes was: 49.4% mild non-proliferative DR (NPDR), 9.1% moderate NPDR, 1.5% severe NPDR, 10.5% proliferative DR (PDR) and 29.5% unspecified DR. Of these, 678 eyes (1.3%) developed SB with a mean follow-up period of 510 days. Two years following baseline DR diagnosis, eyes with severe NPDR and PDR at baseline were 3.6 and 4.0 times more likely, respectively, to develop SB compared with eyes with mild DR. Eyes that developed glaucoma, age-related macular degeneration, retinal vein occlusion, diabetic macular edema, retinal detachment, and vitreous hemorrhage, had an increased risk of developing SB (hazard ratios, 1.96–9.37, p<0.0001). Black and Asian race also increased risk of developing SB (hazard ratios, 1.24, p<0.0001 and 1.27, p<0.011 respectively). (Data not previously published).
Conclusions :
Among eyes with good vision, eyes with more advanced DR at the time of baseline DR diagnosis (severe NPDR or PDR) were significantly more likely to develop SB. SB was also more likely to develop among Black and Asian races. These data highlight the need for close monitoring and appropriate management of patient populations at risk of developing SB.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.