https://scholars.lib.ntu.edu.tw/handle/123456789/545663
標題: | Assessing progression and efficacy of treatment for diabetic retinopathy following the proliferative pathway to blindness: Implication for diabetic retinopathy screening in Taiwan | 作者: | WEN-JING LIU Lee L.-T. Yen M.-F. Tung T.-H. Williams R. Duffy S.W. Chen, Tony Hsiu Hsi |
公開日期: | 2003 | 卷: | 20 | 期: | 9 | 起(迄)頁: | 727-733 | 來源出版物: | Diabetic Medicine | 摘要: | Aims: The natural history and treatment efficacy of diabetic retinopathy (DR) play important roles in the evaluation of screening. Therefore, the natural history of DR and rates of transition after treatment (including metabolic control and laser photocoagulation) from no diabetic retinopathy (NDR) to blindness were quantified. Methods: We studied a cohort of 795 patients with diabetes mellitus (DM) receiving fundus examination in the ophthalmology out-patient department of one medical centre between 1 January 1990 and 31 December 1992 in Taiwan. Follow-up data until 31 December 1998 were collected by chart review. Two multistate Markov models were proposed to assess the efficacy of the treatment regime in reducing progression to blindness. Results: The average times spent in states (i) no diabetic retinopathy (NDR), (ii) background diabetic retinopathy (BDR), (iii) preproliferative diabetic retinopathy (PPDR), and (iv) proliferative retinopathy (PDR) were 10.86 years, 8.33 years, 1.67 years, and 2.17 years, respectively. Early detection of PPDR may lead to a 60% reduction in PDR and an 83% reduction in blindness. Simulated results based on these parameters show that an annual screening programme, a biennial screening regime and a 4-yearly screening regime can lead to 54% (95% confidence interval (CI): 44-62%), 51% (95% CI: 41-59%), and 46% (95% CI: 36-54%) reductions in blindness, respectively. Conclusions: Assessing the progression of DR following the proliferative pathway in this study suggests that screening for DR is worthwhile and that a 4-year interscreening interval for patients as yet without DR may be justified. ? 2003 Diabetes UK. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-0642366762&doi=10.1046%2fj.1464-5491.2003.01019.x&partnerID=40&md5=815d89f265c092b52ae6da064ef9e6b2 https://scholars.lib.ntu.edu.tw/handle/123456789/545663 |
ISSN: | 0742-3071 | DOI: | 10.1046/j.1464-5491.2003.01019.x | SDG/關鍵字: | blindness; confidence interval; diabetes mellitus; diabetic retinopathy; eye fundus; follow up; high risk patient; human; outpatient department; parameter; proliferative retinopathy; retina maculopathy; review; screening; Taiwan; adult; article; blindness; computer simulation; diabetic retinopathy; disease course; evaluation; female; laser coagulation; male; methodology; middle aged; patient compliance; probability; retrospective study; statistics; theoretical model; treatment outcome; vision test; Adult; Blindness; Computer Simulation; Diabetic Retinopathy; Disease Progression; Female; Follow-Up Studies; Humans; Laser Coagulation; Male; Markov Chains; Middle Aged; Models, Theoretical; Patient Compliance; Retrospective Studies; Taiwan; Treatment Outcome; Vision Screening |
顯示於: | 醫學系 |
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