Abstract
Despite recent improvements in the management of blood glucose control and in modern technology such as laser treatment and vitreoretinal surgery, diabetes mellitus is the major systemic cause of blindness in the Western world. The study of the natural history of diabetic retinopathy is difficult because of the variability of the disease, and the numerous factors that may influence its course and outcome. In the many studies available of the natural history of diabetic retinopathy, there is a failure to identify these factors. This article tries to identify and to classify the influences that may modify the outcome and the natural course of diabetic retinopathy, and gives some advice on how to deal with them. They can be subdivided into external, internal and ocular factors. Any future studies of the natural history of diabetic retinopathy are marred by the fact that effective treatment is now established and the guidelines for when to commence treatment and the techniques of treatment are well documented.
Similar content being viewed by others
Article PDF
References
Mills KB . Diabetic retinopathy. Information on opthalmology, booklet 2. Smith & Nephew Pharmaceuticals, Bampton Road, Harold Hill, Romford, Essex RM3 8SL, UK, p 2.
Thompson JR, Du L, Rosenthal AL . Recent trends in the registration of blindness and partial sight in Leicestershire. Br J Ophthalmol 1989;73:95–9.
Early Treatment Diabetic Retinopathy Study Group. Opthalmology (Suppl 5) 1991;98:739–834.
Kohner EM . The evolution and natural history of diabetic retinopathy. Int Ophthalmol Clin 1978;18:1–16.
Diabetic Retinopathy Study Research Group. Preliminary report on the effects of photocoagulation therapy. Am J Ophthalmol 1976;81:383–96.
KROC Collaborative Study Group. Blood glucose control and the evolution of diabetic retinopathy and albuminuria: a preliminary multicenter trial. N Engl J Med 1984;311:365–7.
Brinchmann-Hansen O, Dahl-Jorgensen K, Sandvik L, Hanssen KF . Blood glucose concentrations and progression of diabetic retinopathy: the seven year results of the Oslo Study. BMJ 1992;304:19–22.
Reichard P, Sule J, Rosenqvist U . Capillary loss and leakage after five years of intensified insulin treatment in patients with insulin-dependent diabetes mellitus. Ophthalmology 1991;98:1587–93.
Ulbig M, Kampik A, Thurau S, Landgraf R, Land W . Long-term follow-up of diabetic retinopathy up to 71 months (mean 38 months) after combined renal and pancreatic transplantation. Graefes Arch Clin Exp Ophthalmol 1991;229:242–5.
Engerman RL, Tern TS . Progression of incipient diabetic retinopathy during good glycemic control. Diabetes 1987;36:808–12.
Young RJ, McCulloch DK, Prescott RJ, Clarke BE Alcohol: another risk factor for diabetic retinopathy. BMJ 1984;288:1035–7.
Segato T, Midena E, Grigoletto F, Zucchetto M, Fedele D, Piermarocchi S, Crepaldi G . The epidemiology and prevalence of diabetic retinopathy in the Veneto region of North-East Italy. Diabetic Med 1991;9:11–6.
Moss SE, Klein R, Klein BEK . Alcohol consumption and the prevalence of diabetic retinopathy. Ophthalmology 1992;99:926–32.
Chase HP, Garg SK, Marchshall G . Cigarette smoking increases the risk of albuminuria among subjects with type I diabetes. JAMA 1991;265:614–7.
Moss SE, Klein R, Klein BE . Association of cigarette smoking with diabetic retinopathy. Diabetes Care 1991;14:119–26.
Dodson PM, Gibson JM . Long term follow-up and underlying medical conditions in patients with diabetic exudative maculopathy. Eye 1991;5:699–703.
Beaumont P, Hollows FC . Classification of diabetic retinopathy, with therapeutic implications. Lancet 1972;1:419–24.
Buzney SM, McMeel JW, Field RA . Florid diabetic retinopathy: a role for pituitary ablation. In: Henkind P, editor. Acta XXIV International Congress of Ophthalmology. Philadelphia: Lippincott, 1983: 788.
Knowler WC, Bennet PH, Ballintine EJ . Increased incidence of retinopathy in diabetics with elevated blood pressure; a six-year follow-up study in Pima Indians. N Engl J Med 1980;302:645–50.
Kostraba JN, Klein R, Dorman JS, Becker DJ, Drash AL, Maser RE, Orchard TJ . The epidemiology of diabetes complications. IV. Correlates of diabetic background and proliferative retinopathy. Am J Epidemiol 1991;133:381–91.
Khauli RB, Novick AC, Steinmuiller DR, Buszta C, Nakamoto S, Vidt DG, et al. Comparison of renal transplantation and dialysis in rehabilitation of diabetic endstage renal disease patients. Urology 1986;27:521–5.
Janovic-Peterson L, Peterson CM . Diabetic retinopathy. Clin Obstet Gynecol 1991;34:516–25.
Merimee TJ . A follow-up study of vascular disease in growth hormone deficient dwarfs with diabetes. N Engl J Med 1978;298:–1217.
Merimee TJ . Diabetic retinopathy: a synthesis of perspectives. N Engl J Med 1990;322:978–83.
Boulton M, Patel B, Khaliq A, Moriarty P, Jarvis-Evans J, McLeod D . Modulators and milieu in preretinal neovascularisation. Eye 1992;6:650–5.
Akiba J, Arzabe C, Trempe C . Posterior vitreous detachment and neovascularization in diabetic retinopathy. Ophthalmology 1991;;97;889–91.
Hiscott P, Cooling RJ, Rosen P, Garner A . The pathology of abortive neovascular outgrowths from the retina. Graefes Arch Clin Exp Ophthalmol 1992;230:531–6.
Benson WE . Cataract surgery and diabetic retinopathy. Curr Opin Ophthalmol 1992;3:396–400.
Lewis H, Abrams GW, Williams GA . Anterior hyaloidal fibrovascular proliferation after diabetic vitrectomy. Am J Ophthalmol 1987;104:607–13.
Ulbig MRW, Hykin PG, Foss AJE, Schwartz SD, Hamilton AMP . Anterior hyaloidal fibrovascular proliferation following cataract surgery in diabetic eyes. Am J Ophthalmol 1993;115:321–6.
Green WR . Systemic disease with retinal involvement. In: Spenser WH, editor. Ophthalmic pathology: an atlas and textbook. 3rd ed. Philadelphia: Saunders, 1986:1034–210.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Ulbig, M., Hamilton, A. Factors influencing the natural history of diabetic retinopathy. Eye 7, 242–249 (1993). https://doi.org/10.1038/eye.1993.57
Issue Date:
DOI: https://doi.org/10.1038/eye.1993.57
Keywords
This article is cited by
-
Is primary open-angle glaucoma a risk factor for diabetic retinopathy?
International Ophthalmology (2020)
-
Ipsilateral proliferative diabetic retinopathy in carotid stenosis
Eye (2001)
-
Modifying factors related to asymmetric diabetic retinopathy
Eye (1998)
-
Diabetic eye disease: A natural history study
Eye (1997)
-
Gyrate atrophy of the choroid and retina with hyperornithinaemia, cystinuria and lysinuria
Eye (1994)