Abstract
Purpose :
Screening for diabetic retinopathy is aimed at detecting either of the two vision threatening complications proliferative diabetic retinopathy (PDR) and diabetic maculopathy with clinically significant macular edema (DME). The purpose of the present study was to investigate whether known risk factors for the development and progression of retinopathy may affect the risk for developing the two treatment end points differently.
Methods :
Survival analysis was used to describe systemic risk factors for the development of PDR and DME from all 2,773 patients treated for PDR and DME between July 1. 1994 and July 1. 2019 from a population of approximately 900,000 citizens in the Aarhus area, Denmark. The explanatory co-variates were gender, known age of onset of diabetes, body mass index (BMI), and the weighted exposure to hemoglobin A1c (HbA1c), diastolic (DBP) and systolic (SBP) blood pressure.
Results :
The risk for developing both PDR and DME was lowest in patients with normal wHbA1c and increased for both higher and lower HbA1c values (p<0.013). Increasing DBP increased the risk for developing both PDR and DME (p<0.0001), whereas increasing SBP increased the risk for developing DME (p<0.0001), but not PDR (p>0.08). The risk for developing PDR increased and for developing DME decreased with increasing (BMI) (p< 0.02). The risk for developing PDR increased with decreasing age of onset of diabetes (p<0.0001), whereas the risk for developing DME was maximal for an onset of diabetes around 30 of age, and decreased significantly for both lower and higher ages of onset (p<0.0001).
Conclusions :
Systemic risk factors such as systolic blood pressure, BMI and the age of onset of diabetes contribute differently to the development of PDR and DME. This suggests that the overall risk for developing one of the two vision threatening complications could be calculated as the sum of the risks for reaching each of the two complications separately.
This is a 2020 ARVO Annual Meeting abstract.