title: Improving visual prognosis of the diabetic patients during the past 30 years based on the data of the Finnish Register of Visual Impairment.
abstract: OBJECTIVE
  To evaluate changes in visual impairment (VI) due to diabetic retinopathy (DR) recorded in the Finnish Register of Visual Impairment (RVI) during the past 30 years.
  
  
  METHODS
  Data from the visually impaired diabetic persons included in the RVI were analysed using three 10-year cohorts (1982-90, 1991-2000, 2001-10). Information on the age at the time of the first VI registration, severity of VI determined according to the World Health Organisation (WHO) definition, and the age at death was collected. VI due to proliferative (PDR) and non-proliferative (NPDR) DR were analysed separately.
  
  
  RESULTS
  Data of 4080 patients whose primary cause for VI was DR were analysed. The median age at the time of notification of VI for the three cohorts was 39, 62 and 59 years in the PDR group and 71, 73 and 73 in the NPDR group, respectively. The proportion of blind persons was 42%, 22% and 15% in the PDR group and 10%, 9% and 4% in the NPDR group, respectively. The median age at death in the three cohorts was 54, 73 and 72 years in PDR group and 76, 79 and 80 years in the NPDR group, respectively. The standardized mortality ratio (SMR) compared with the general population was 8.3, 2.9 and 1.4 in persons with PDR and 3.4, 2.0 and 1.2 in those with NPDR, respectively.
  
  
  CONCLUSIONS
  A significant change in the profile of the VI in the PDR group has taken place in Finland. It was characterized by increased age at the time of VI notification, decreased severity of VI and higher age at death. Most evidently these improvements took place in the 1990s. The profile of VI in the NPDR group has changed only modestly. Compared with the general population, SMRs improved both in NPDR and PDR groups continuously.
authors.affiliation: Department of Ophthalmology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
authors.forename: Leila
authors.initials: L
authors.lastname: Laatikainen
authors.affiliation: The Finnish Register of Visual Impairment, Helsinki, Finland.|The National Institute for Health and Welfare, Helsinki, Finland.|The Finnish Federation of the Visually Impaired, Helsinki, Finland.
authors.forename: Matti
authors.initials: M
authors.lastname: Ojamo
authors.affiliation: The Finnish Register of Visual Impairment, Helsinki, Finland.|The Finnish Federation of the Visually Impaired, Helsinki, Finland.
authors.forename: Sirkka-Liisa
authors.initials: SL
authors.lastname: Rudanko
authors.affiliation: Department of Ophthalmology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
authors.forename: Paula
authors.initials: P
authors.lastname: Summanen
authors.affiliation: Center for Life Course Epidemiology and Personalized Medicine, University of Oulu, Oulu, Finland.|Unit of Primary Health Care, Oulu University Hospital, Oulu, Finland.
authors.forename: Sirkka
authors.initials: S
authors.lastname: Keinänen-Kiukaanniemi
authors.affiliation: The National Institute for Health and Welfare, Helsinki, Finland.|Centre for Vascular Prevention, Danube-University Krems, Krems, Austria.|Diabetes Research Group, King Abdulaziz University, Jeddah, Saudi Arabia.
authors.forename: Jaakko
authors.initials: J
authors.lastname: Tuomilehto
authors.affiliation: Center for Life Course Epidemiology and Personalized Medicine, University of Oulu, Oulu, Finland.|Unit of Primary Health Care, Oulu University Hospital, Oulu, Finland.
authors.forename: Sauli
authors.initials: S
authors.lastname: Herrala
authors.affiliation: The Finnish Register of Visual Impairment, Helsinki, Finland.|The National Institute for Health and Welfare, Helsinki, Finland.|SILK, Department of Ophthalmology, University of Tampere and Tays Eye Center, Tampere, Finland.
authors.forename: Hannu
authors.initials: H
authors.lastname: Uusitalo
mesh_terms: D000328:Adult; D000368:Aged; D003922:Diabetes Mellitus, Type 1 / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology; D003930:Diabetic Retinopathy / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012042:Registries; D014786:Vision Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D014792:Visual Acuity / Q000502:physiology*; D019987:Persons with Visual Disabilities / Q000706:statistics & numerical data*
keywords: blindness; diabetes mellitus; diabetic retinopathy; health registers; low vision; mortality rate; visual impairment