Occurrence and predictors of retinopathy and visual acuity in Type 2 diabetic patients and control subjects 10-year follow-up from the diagnosis

The evolution of visual acuity and retinopathy and their risk factors in pa tients with newly diagnosed type 2 diabetes and in control subjects. A 10-y ear prospective study consisting of a representative group of 133 (70 men, 63 women) newly diagnosed type 2 diabetic patients diagnosed at hearth cent ers between 1979 and 1981 and 144 (62 men, 82 women) non-diabetic control s ubjects recruited from the population register. The frequency of retinopath y was determined by grading of 45 degrees fundus photographs at baseline an d after 5 and 10 years. By the 10-year follow-up the diabetic patients had lower visual acuity than the control subjects. The impairment of the visual acuity correlated inversely to HbA(1C) value of the 5-year examination. Th e frequency of retinopathy in type 2 diabetic patients increased sharply af ter 5 years and at 10-year 55% of diabetic patients had signs of retinopath y. The frequency of recinopathy in the control subjects was low, but detect able. In the diabetic patients poor glycemic control was the most important predictive factor for the development of retinopathy. In the control subje cts blood pressure levels were higher and microalbuminuria more common in t hose with than in those without retinopathy. The visual acuity deteriorated and the frequency of retinopathy increased in newly diagnosed type 2 diabe tic patients with duration of disease and poor glycemic control. Interestin gly, higher blood pressure levels and microalbuminuria predicted retinopath y in control subjects. (C) 2001 Elsevier Science Inc. All rights reserved.