A small number of older type 2 diabetic patients end up visually impaired despite regular photographic screening and laser treatment for diabetic retinopathy.
OBJECTIVE
The present study describes the prevalence of visual impairment and blindness in a geographically defined population 8 years after the introduction of a screening programme in 1987 for early detection of sight-threatening diabetic retinopathy.


METHODS
Of 374 patients with diabetes, comprising 2.6% of the population in the study community, 72% were examined with fundus photography or biomicroscopy during 1994-95. These patients form the basis of this study. The screening programme was fulfilled by 93% of subjects, all of whom underwent ophthalmic examinations at least every other year. A total of 79 eyes in 52 patients received photocoagulation for macular oedema alone or in combination with severe non-proliferative or proliferative retinopathy.


RESULTS
Eight years after the implementation of the programme, only three patients, all with type 2 diabetes (diabetes diagnosed at or after 30 years of age), had visual acuity < or = 0.1. The total number of eyes with visual acuity < or = 0.5 was higher in insulin-treated type 2 diabetic patients (n = 20) than in those on oral treatment (n = 5) or diet treatment only (n = 1) (p = 0.006 in both cases). The only independent risk factor for visual impairment in eyes with sight-threatening retinopathy was age.


CONCLUSIONS
A small number of older type 2 diabetic patients end up with visual impairment due to unsuccessful photocoagulation of macular oedema.
Hansson-Lundblad
Catharina
C
Department of Ophthalmology, Malmö University Hospital, Malmö, Sweden.
Holm
Kristina
K
Agardh
Carl-David
CD
Agardh
Elisabet
E
D000293:Adolescent; D000328:Adult; D000368:Aged; D001766:Blindness / Q000453:epidemiology* / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D003930:Diabetic Retinopathy / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D017075:Laser Coagulation; D008297:Male; D008875:Middle Aged; D010781:Photography; D015995:Prevalence; D012307:Risk Factors; D013548:Sweden / Q000453:epidemiology; D014786:Vision Disorders / Q000453:epidemiology* / Q000209:etiology; D015351:Vision Screening / Q000379:methods; D014792:Visual Acuity; D019987:Persons with Visual Disabilities / Q000706:statistics & numerical data*