Subclassification of preproliferative diabetic retinopathy and glycemic control: Relationship between mean hemoglobin A(1C) value and development of proliferative diabetic retinopathy
Y. Sato et al., Subclassification of preproliferative diabetic retinopathy and glycemic control: Relationship between mean hemoglobin A(1C) value and development of proliferative diabetic retinopathy, JPN J OPHTH, 45(5), 2001, pp. 523-527
Purpose: We evaluated the relationship between long-term glycemic control a
nd the proportion of patients developing proliferative diabetic retinopathy
(PDR) among cases with mild type preproliferative diabetic retinopathy (PP
DR).
Methods: The relationship was evaluated between the mean hemoglobin A(1C) (
HbA(1C)) value during a period of at least 2 years and the proportion of pa
tients developing PDR among cases with mild type PPDR, based on our previou
sly proposed subclassification.
Results: During follow-up, 27% of the total PPDR cases developed PDR. The m
ean HbA(1C) value in those patients who had developed PDR was 9.4% and was
significantly higher than the 7.6% in those who had not developed PDR. The
proportion developing PDR was 48% of the cases with a mean HbA(1C) value of
8.6% or more. By comparison, the proportion developing PDR was 8% among th
ose with a mean HbA(1C) value below 8.6%. The proportion developing PDR was
estimated to approximately double with each 1% increase in the mean HbA(1C
) value. The cumulative occurrence rates of PDR at 2, 5, and 10 years were
estimated to be 5%, 28%, and 60% in cases with a mean HbA(1C) value of 8.6%
or more, and 0%, 7%, and 14% in those with a mean HbA(1C) value below 8.6%
, respectively.
Conclusion: Stricter systemic and ophthalmological control is indicated for
cases with a mean HbA(1C) value exceeding 8.6%. Jpn J Ophthalmol 2001;45:5
23-527 (C) 2001 Japanese Ophthalmological Society.