Age-related macular degeneration in newly diagnosed type 2 diabetic patients and control subjects - A 10-year follow-up on evolution, risk factors, and prognostic significance

OBJECTIVE - To investigate the evolution of visual acuity, age-related macu lar degeneration (AMD),and its relation to 10-year cardiovascular mortality and risk factors in patients with newly diagnosed type 2 diabetes and cont rol subjects. RESEARCH DESIGN AND METHODS - A 10-year prospective study consisting of a r epresentative group of 133 (70 men, 63 women) newly diagnosed type 2 diabet ic patients diagnosed at health centers between 1979 and 1981 and 144 (62 m en, 82 women) nondiabetic control subjects recruited from the population re gister was performed. The Frequency of AMD was determined by grading of 45 degrees stereoscopic fundus photographs. The subjects were studied at basel ine and after 5 and 10 years. RESULTS - By the 10-year follow-up, visual acuity had declined more markedl y in the diabetic patients than in the control subjects. Although the frequ ency of AMD was nearly the same in both groups (11-19%), it decreased visua l acuity earlier in the diabetic patients than in the control group. AMD at baseline predicted 10-year cardiovascular mortality independently of adjus tment for other risk factors in the diabetic patients (odds ratio [95% CI] 4.7 [1.1-19.3], P = 0.033). CONCLUSIONS - Visual acuity deteriorated earlier in newly diagnosed type 2 diabetic patients than in the control group although the cross-sectional fr equency of AMD was nearly the same in both groups. Interestingly, AMD was a n independent risk factor for cardiovascular mortality in type 2 diabetic p atients, but the background mechanism(s) behind this association is unknown .