June 2022
Volume 63, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2022
Presence and development of diabetic retinopathy in the Danish Registry of Diabetic Retinopathy.
Author Affiliations & Notes
  • Jakob Grauslund
    Ophthalmology, Odense Universitetshospital, Odense, Syddanmark, Denmark
    Steno Diabetes Center Odense, Odense Universitetshospital, Odense, Syddanmark, Denmark
  • Frederik Pedersen
    Ophthalmology, Odense Universitetshospital, Odense, Syddanmark, Denmark
  • Nis Andersen
    Lageforeningen, Kobenhavn, Hovedstaden, Denmark
  • Jens Andresen
    Lageforeningen, Kobenhavn, Hovedstaden, Denmark
  • Toke Bek
    Aarhus Universitet, Aarhus, Midtjylland, Denmark
  • Morten la Cour
    Rigshospitalet, Kobenhavn, Denmark
  • Sebastian Dinesen
    Ophthalmology, Odense Universitetshospital, Odense, Syddanmark, Denmark
  • Javad Hajari
    Rigshospitalet, Kobenhavn, Denmark
  • Kurt Højlund
    Steno Diabetes Center Odense, Odense Universitetshospital, Odense, Syddanmark, Denmark
  • Caroline Laugesen
    Sjaellands Universitetshospital Roskilde, Roskilde, Sjaelland, Denmark
  • Ryo Kawasaki
    Osaka Daigaku Daigakuin Igakukei Kenkyuka Igakubu, Suita, Osaka, Japan
  • Sören Möller
    Clinical Research, Syddansk Universitet Det Sundhedsvidenskabelige Fakultet, Odense, Syddanmark, Denmark
  • Katja Schielke
    Aalborg Universitetshospital, Aalborg, North Denmark Region, Denmark
  • Anne Thykjær
    Ophthalmology, Odense Universitetshospital, Odense, Syddanmark, Denmark
  • Lonny Stokholm
    OPEN, Odense Universitetshospital, Odense, Syddanmark, Denmark
  • Footnotes
    Commercial Relationships   Jakob Grauslund Bayer, Novartis, Allergan, Roche, Code C (Consultant/Contractor); Frederik Pedersen None; Nis Andersen None; Jens Andresen None; Toke Bek None; Morten la Cour None; Sebastian Dinesen None; Javad Hajari None; Kurt Højlund None; Caroline Laugesen None; Ryo Kawasaki None; Sören Möller None; Katja Schielke None; Anne Thykjær None; Lonny Stokholm None
  • Footnotes
    Support  VELUX FONDEN (grant number 00028744)
Investigative Ophthalmology & Visual Science June 2022, Vol.63, 812. doi:
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      Jakob Grauslund, Frederik Pedersen, Nis Andersen, Jens Andresen, Toke Bek, Morten la Cour, Sebastian Dinesen, Javad Hajari, Kurt Højlund, Caroline Laugesen, Ryo Kawasaki, Sören Möller, Katja Schielke, Anne Thykjær, Lonny Stokholm; Presence and development of diabetic retinopathy in the Danish Registry of Diabetic Retinopathy.. Invest. Ophthalmol. Vis. Sci. 2022;63(7):812.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To evaluate the prevalence of diabetic retinopathy (DR) and 5-year rates of incident DR, 2-step-or-more progression of DR, as well as progression to proliferative DR along with associated markers in a Danish national cohort.

Methods : We included all persons in the Danish Registry of Diabetic Retinopathy, who had attended at least one episode of DR-screening in 2013-2018. DR was classified by the International Clinical Diabetic Retinopathy Severity Scale with levels 0-4 indicating increasing severity. Data were linked with various national databases to indicate type and duration of diabetes, marital status, comorbidity, systemic medication and screening facility. Baseline DR-level at the worse eye was used for analysis.

Results : Among 170,237 persons with diabetes, mean (with interquartile range) age and duration of diabetes were 65.7 (55.5-73.1) and 5.9 (2.2-11.0) years, respectively, 56.6% were male, and 90.0% had type 2 diabetes. DR-prevalence and 5-year incidences of DR, 2-step-or-more progression of DR and progression to proliferative DR were 12.4%, 4.6%, 0.9% and 0.4%, respectively. The highest rates were found in those below 30 years (21.6%, 13.2%, 2.8%, and 1.2%), with type 1 diabetes (44.2%, 16.0%, 3.4%, and 2.3%), duration of diabetes above 20 years (57.3%, 16.2%, 3.5%, and 2.8%), using insulin (31.8%, 11.0%, 2.4%, and 1.3%), and attending screening at a hospital facility (33.6%, 10.3%, 2.6%, and 1.3%). In multivariable models, use of insulin was identified as a leading marker of all four outcomes (odds ratio 2.24, 95% confidence interval [CI] 2.14-2.34, hazard ratio [HR] 1.90, 95% CI 1.78-2.03, HR 2.23, 95% CI 1.94-2.56, and HR 2.68, 95% CI 2.09-3.43). On the other hand, gender, marital status, Charlson Comorbidity Index score, non-insulin glucose lowering therapy, antihypertensive or cholesterol lowering treatment did not consistenly affect the risk of DR. For patients who entered the registry in the years of 2013, 2014 and 2015, risks of progression to proliferative DR decreased continuously (2.13 vs. 0.97 vs. 0.45, and 2.72 vs. 1.12 vs. 0.70 events per 1,000 person-years for 1- and 3-year progression, respectively).

Conclusions : In a 5-year longitudinal study of a national cohort of persons attending DR-screening, we identified low age, type 1 diabetes, long duration of diabetes, and in particular use of insulin as the most important markers of presence and development of DR.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.

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