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First Incidence and Progression Study for Diabetic Retinopathy in Portugal, the RETINODIAB Study: Evaluation of the Screening Program for Lisbon Region

2015-12Journal article Open access
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dc.contributor.authorDutra Medeiros, M
dc.contributor.authorMesquita, E
dc.contributor.authorGardete-Correia, L
dc.contributor.authorMoita, J
dc.contributor.authorGenro, V
dc.contributor.authorPapoila, AL
dc.contributor.authorAmaral-Turkman, A
dc.contributor.authorRaposo, JF
dc.date.accessioned2017-10-24T15:26:01Z
dc.date.available2017-10-24T15:26:01Z
dc.date.issued2015-12
dc.description.abstractPURPOSE: To estimate the 5-year incidence and progression of diabetic retinopathy (DR) among persons with type 2 diabetes mellitus (DM). DESIGN: Population-based, prospective, cohort study. PARTICIPANTS: The RETINODIAB (Study Group for Diabetic Retinopathy Screening) program was implemented in the Lisbon and Tagus Valley area between July 2009 and December 2014. A total of 109 543 readable screening examinations were performed and corresponded to 56 903 patients who attended the screening program at entry. A total of 30 641 patients (53.85%) had at least 1 further screening event within the study period and were included in the analysis. METHODS: Participants underwent two 45° nonstereoscopic retinal digital photographs per eye according to RETINODIAB protocol. All images were graded according to the International Clinical Diabetic Retinopathy Scale. Referable diabetic retinopathy (RDR) was defined for all patients graded as moderate nonproliferative DR (NPDR), severe NPDR, or proliferative DR (PDR), with or without maculopathy or mild NPDR with maculopathy. Nonparametric estimates of the annual and cumulative incidences were obtained by Turnbull's estimator. Associations between the potential risk factors and the time to onset/progression of retinopathy were assessed through a parametric survival analysis for interval-censored data. MAIN OUTCOME MEASURES: The authors estimated the onset and progression incidence rates of DR. RESULTS: Yearly incidence of any DR in patients without retinopathy at baseline was 4.60% (95% confidence interval [CI], 3.96-4.76) in the first year, decreasing to 3.87% (95% CI, 2.57-5.78) in the fifth year. In participants with mild NPDR at baseline, the progression rate to RDR in year 1 was 1.18% (95% CI, 0.96-1.33). Incidence of any DR and RDR and DR progression rate were associated with known duration of diabetes, age at diagnosis, and use of insulin treatment. CONCLUSIONS: This longitudinal epidemiologic study provides the first Portuguese incidence DR data in a large-scale population-based cohort of type 2 diabetes after a 5-year follow-up. Duration of diabetes, age at diagnosis, and insulin treatment were associated with increasing risk of incidence and progression of DR. A personalized schedule distribution of screening intervals according to the individual patient's profile should be implemented, with resulting benefits in terms of health costs.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationOphthalmology. 2015 Dec;122(12):2473-81pt_PT
dc.identifier.doi10.1016/j.ophtha.2015.08.004pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/2773
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherElsevierpt_PT
dc.subjectAgedpt_PT
dc.subjectDiabetes Mellitus, Type 2pt_PT
dc.subjectDiabetic Retinopathypt_PT
dc.subjectDisease Progressionpt_PT
dc.subjectEpidemiologic Studiespt_PT
dc.subjectFemalept_PT
dc.subjectHumanspt_PT
dc.subjectIncidencept_PT
dc.subjectLongitudinal Studiespt_PT
dc.subjectMalept_PT
dc.subjectMass Screeningpt_PT
dc.subjectMiddle Agedpt_PT
dc.subjectPortugalpt_PT
dc.subjectProspective Studiespt_PT
dc.subjectRisk Factorspt_PT
dc.subjectCHLC OFTpt_PT
dc.titleFirst Incidence and Progression Study for Diabetic Retinopathy in Portugal, the RETINODIAB Study: Evaluation of the Screening Program for Lisbon Regionpt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage2481pt_PT
oaire.citation.issue12pt_PT
oaire.citation.startPage2473pt_PT
oaire.citation.titleOphthalmologypt_PT
oaire.citation.volume122pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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