Original articleA study of the 3-year incidence of diabetic retinopathy in a French diabetic population seen at Lariboisière Hospital, ParisÉtude de l’incidence durant trois ans de la rétinopathie diabétique dans une population suivie à l’hôpital Lariboisière à Paris
Introduction
Diabetic retinopathy (DR) is the primary cause of legal blindness in Western countries [1]. Better management of diabetic patients and, in particular, better glycaemic control, lower blood pressure [2], [3] and regular eye follow-up [4], [5], have reduced both the incidence and progression of DR in several countries. However, screening for DR remains a major public-health issue because of the alarming increase in the prevalence of diabetes around the world. In France between 2000 and 2009, the number of people treated for diabetes increased from 2.6% to 4.4% of the population [6]. Access to an ophthalmologist is difficult in France, and this remains a genuine handicap for proper follow-up. In response to these two problems, the telemedical network OPHDIAT® was specifically designed to facilitate access to regular annual eye evaluations in patients with diabetes [7]. The network was set up in 2004 and, since then, it has continued to function routinely.
The purpose of the present study was to evaluate the incidence of DR over a 3-year period in a French population that was followed-up by this network, and to assess the clinical and biological risk factors associated with incident retinopathy.
Section snippets
Study population
This retrospective study included 254 diabetic patients, whatever their type of diabetes, who visited the endocrinology department of the Lariboisière Hospital in Paris, France, between 2004 and 2011. All of the patients studied were screened for DR during hospitalization for their annual diabetes check-up by two examinations three years apart.
Procedure
All patients in the study underwent complete examinations during hospitalization that included:
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a questionnaire detailing the time since diabetes onset,
Results
A total of 254 patients were studied. At baseline, 236 patients (93%) showed no DR whereas 18 patients (7%) did. These 18 patients were not included in the calculation of the incidence of DR. At the 3-year follow-up, retinopathy had developed in 33 of the 236 patients in whom retinopathy was not present at baseline, thereby giving an incidence of 14.0% (CI: 9.5–18.4%; Table 1). Neither severe non-proliferative diabetic retinopathy (NPDR) nor any proliferative DR was found in our study. On
Discussion
Our present study showed the rate of incident retinopathy after three years of follow-up, while most epidemiological studies have used a 5-year follow-up timescale. For this reason and to compare studies, the incidences are presented here as annual rates.
Our results are similar to those of the Blue Mountains Eye Study (BMES), which had an incidence at five years of 22.2% [10], but are significantly higher than those of the Australian Diabetes, Obesity and Lifestyle (AusDiab) study [11] and the
Disclosure of interest
The authors declare that they have no conflicts of interest concerning this article.
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