Abstract
Data from the Diabetic Retinopathy Study [1] and the Early Treatment Diabetic Retinopathy Study [2], demonstrated the efficacy of photocoagulation treatment in preventing visual loss associated with proliferative diabetic retinopathy. However, clinical trial data demonstrating the efficacy of medical interventions for this disease have only become available within the last decade. Nonsurgical interventions prior to the development of severe retinopathy are important because photocoagulation is associated with complications and in some cases may not prevent the progression of retinopathy, resulting in visual loss. The purpose of this review is to examine data from ongoing and completed randomized controlled clinical trials of medical interventions to reduce the progression of retinopathy and loss of vision in persons with diabetes.
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References
Diabetic Retinopathy Study Group. Photocoagulation treatment of proliferative diabetic retinopathy: clinical application of Diabetic Retinopathy Study (DRS) findings. DRS Report No. 8. Ophthalmology 1981; 88: 583–600.
ETDRS Research Group. Photocoagulation for diabetic macular edema. Arch Ophthalmol 1985; 103: 1796–1806.
University Group Diabetes Program. Effects of hypoglycemic agents on vascular complications in patients with adult-onset diabetes. VIII. Evaluation of insulin therapy: final report. Diabetes 1982; 31: 1–81.
Klein R, Klein BEK, Moss SE, Davis MD, DeMets SL. Glycosylated hemoglobin predicts the incidence and progression of diabetic retinopathy. JAMA 1988; 260: 2864–2871.
Klein R, Klein BEK, Moss SE, Davis MD, DeMets DL. The Wisconsin Epidemiologic Study of Diabetic Retinopathy. IV. Diabetic macular edema. Ophthalmology 1984; 91: 1464–1474.
The Kroc Collaborative Study Goup. Diabetic retinopathy after two years of intensified insulin treatment: follow-up of The Kroc Collaborative Study. JAMA 1988; 260: 37–41.
Lauritzen T, Frost-Larsen K, Larsen HW, Deckert T, Steno Study Group. Two-year experience with continuous subcutaneous insulin infusion in relation to retinopathy and neuropathy. Diabetes 1985; 34: 74–79.
Dahl-Jorgensen K, Brinchmann-Hansen O, Hanssen KF, Ganes T, Kierulf P, Smeland E, Sandvik L, Aagenaes O. Effect of near normoglycemia for two years on progression of early diabetic retinopathy, nephropathy, and neuropathy: The Oslo Study. Br Med J 1986; 293: 1995–1999.
The Diabetes Control and Complications Trial Research Group. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med 1993; 329: 977–986.
The Diabetes Control and Complications Trial Research Group. The effect of intensive diabetes treatment on the progression of diabetic retinopathy in insulin-dependent diabetes mellitus: The Diabetes control and Complications Trial. Arch Ophthalmol 1995; 113: 36–51.
The_Diabetes Control and Complications Trial Research Group. Progression of retinopathy with intensive versus conventional treatment in the Diabetes Control and Complications Trial. Ophthalmology 1995; 102: 647–661.
The Diabetes Control and Complications Trial Research Group. The absence of a glycemic threshold for the development of long-term complications: The perspective of the Diabetes Control and Complications Trial. Diabetes 1996: 1289–1298.
The Diabetes Control and Complications Trial Research Group. Lifetime benefits and costs of intensive therapy as practiced in the Diabetes Control and Complications Trial. JAMA 1996; 276: 1409–1415.
The Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Research Group. Retinopathy and nephropathy in patients with type 1 diabetes four years after a trial of intensive therapy. N Engl J Med 2000; 342: 381–389.
UK Prospective Diabetes Study Group. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes. UKPDS 33. Lancet 1998; 352: 837–853.
UK Prospective Diabetes Study Group. Effective of intensive blood-glucose control with metformin on complications in overweight patients with type 2 diabetes (UKPDS 34). Lancet 1998; 352: 854–865.
Gray A, Raikou M, McGuire A, et al. Cost effectiveness of an intensive blood glucose control policy in patients with type 2 diabetes: economic analysis alongside randomised controlled trial (UKPDS 41). BMJ 2000; 320: 1373–1378.
American Diabetes Association. Position statement: Standards of medical care for patients with diabetes mellitus. Diabetes Care 1995; 19: 8–15.
Harris ML Health care and health status and outcomes for patients with type 2 diabetes. Diabetes Care 2000; 23: 754–758.
Klein R, Klein BEK, Moss SE, Cruickshanks KJ. The medical management of hyperglycemia over a 10-year period in people with diabetes. Diabetes Care 1996; 19: 744–750.
Davis MD. Diabetic retinopathy, diabetic control, and blood pressure. Transplant Proc 1986; 18: 1565–1568.
Klein R, Klein BEK. Vision disorders in diabetes. In: Harris MI, Cowie CC, Stern MP, Boyko EJ, Reiber GE, Bennett PH (ed), Diabetes in America, 2nd Ed. National Institutes of Health NIH Publication No. 95-1468; 1995, pp 293–338.
Adler A, Stratton IM, Neil HAW, et al. Association of systolic blood pressure with macrovascular and microvascular complicaitons of type 2 diabetes (UKPDS 36): prospective observational study. B Med J 2000: 412–419.
Klein R, Klein BEK, Moss SE, Cruickshanks KJ. The Wisconsin Epidemiologic Study of Diabetic Retinopathy. XVII. The 14-year incidence and progression of diabetic retinopathy and associated risk factors in Type 1 diabetes. Ophthalmology 1998; 105: 1801–1815.
Chaturvedi N, Sjolie, Stephenson JM, et al. Effect of lisinopril on progression of retinopathy in normotensive people with type 1 diabetes: the EUCLID Study Group. EURODIAB Controlled Trial of Lisinopril in Insulin-Dependent Diabetes Mellitus. Lancet 1998; 351: 28–31.
Chaturvedi N. Modulation of the renin-angiotensin system and retinopathy. Heart 2000; 84: i29–i31.
UK Prospective Diabetes Study Group. Tight blood pressure control and risk of macrovascular and microvascular complications in Type 2 diabetes. UKPDS 38. Br Med J 1998; 317: 703–713.
Savage S, Johnson NL, Estacio RO, et al. The ABCD [Appropriate Blood Pressure Control in Diabetes] Trial: rationale and design of a trial of hypertension control (moderate or intensive) in Type II diabetes. Online Journal of Current Clinical Trials, Doc no. 104, 1993.
Duncan LJP, Cullen JF, Ireland JT, Nolan J, Oliver MF. A three-year trial of Atromid therapy in exudative diabetic retinopathy. Diabetes 1968; 17: 458–467.
Klein BEK, Moss SE, Klein R, Suawicz TS. The Wisconsin Epidemiologic Study of Diabetic Retinopathy. XIII: relationship of serum cholesterol to retinopathy and hard exudate. Ophthalmology 1991; 98: 1261–1265.
Chew EY, Klein ML, Ferris FL III, et al. Association of elevated serum lipid levels with retinal hard exudate in diabetic retinopathy. ETDRS Report Number 22. Arch Ophthalmol 1996; 114: 1079–1084.
Sorbinil Retinopathy Trial Research Group. A randomized trial of sorbinil, an aldose reductase inhibitor in diabetic retinopathy. Arch Ophthalmol 1990; 108: 1234–1244.
Early Treatment Diabetic Retinopathy Study Research Group. Effects of aspirin treatment on diabetic retinopathy. ETDRS Report Number 8. Ophthamology 1991; 98: 757–765.
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© 2002 Springer Science+Business Media Dordrecht
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Klein, R.I., Klein, B.E.K. (2002). Medical Approaches to Preventing Vision Loss from Diabetic Retinopathy. In: Friedman, E.A., L’Esperance, F.A. (eds) Diabetic Renal-Retinal Syndrome. Springer, Dordrecht. https://doi.org/10.1007/978-94-010-0614-9_7
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DOI: https://doi.org/10.1007/978-94-010-0614-9_7
Publisher Name: Springer, Dordrecht
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