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The Importance of Close Follow-Up in Patients with Early-Grade Diabetic Retinopathy: A Taiwan Population-Based Study Grading via Deep Learning Model

(1) Background: Diabetic retinopathy (DR) can cause blindness. Current guidelines on diabetic eye care recommend more frequent eye examinations for more severe DR to prevent deterioration. However, close follow-up and early intervention at earlier stages are important for the prevention of disease p...

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Autores principales: Lee, Chia-Cheng, Hsing, Shi-Chue, Lin, Yu-Ting, Lin, Chin, Chen, Jiann-Torng, Chen, Yi-Hao, Fang, Wen-Hui
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8470712/
https://www.ncbi.nlm.nih.gov/pubmed/34574686
http://dx.doi.org/10.3390/ijerph18189768
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author Lee, Chia-Cheng
Hsing, Shi-Chue
Lin, Yu-Ting
Lin, Chin
Chen, Jiann-Torng
Chen, Yi-Hao
Fang, Wen-Hui
author_facet Lee, Chia-Cheng
Hsing, Shi-Chue
Lin, Yu-Ting
Lin, Chin
Chen, Jiann-Torng
Chen, Yi-Hao
Fang, Wen-Hui
author_sort Lee, Chia-Cheng
collection PubMed
description (1) Background: Diabetic retinopathy (DR) can cause blindness. Current guidelines on diabetic eye care recommend more frequent eye examinations for more severe DR to prevent deterioration. However, close follow-up and early intervention at earlier stages are important for the prevention of disease progression of other diabetes mellitus (DM) complications. The study was designed to investigate the association between different stages of DR in type 2 DM patients and the progression of DR; (2) Methods: A total of 2623 type 2 DM patients were included in this study. In these patients, a total of 14,409 fundus color photographs was obtained. The primary outcome was the progression of DR; (3) Results: The progression of DR was highly associated with the initial grade of DR (p < 0.001). Severe nonproliferative diabetic retinopathy (NPDR) was the most likely to progress to proliferative diabetic retinopathy (PDR), followed by moderate NPDR, mild NPDR, and no retinopathy. However, progression to the next stage of DR showed a different trend. We used no retinopathy as a reference. Mild NPDR showed the highest risk for progression to the next stage [hazard ratio (HR): 2.00 (95% conference interval (CI): 1.72–2.32)] relative to higher initial grades [HR (moderate NPDR): 1.82 (95% CI: 1.58–2.09) and HR (severe NPDR): 0.87 (95% CI: 0.69–1.09)]. The same trend was observed in the multivariate analysis, in which mild NPDR presented the highest risk for progression to the next stage (adjusted HR (mild NPDR): 1.95 (95% CI: 1.68–2.27), adjusted HR (moderate NPDR): 1.73 (95% CI: 1.50–1.99), and adjusted HR (severe NPDR): 0.82 (95% CI: 0.65–1.03)); (4) Conclusions: Type 2 diabetic patients with earlier-grade DR appeared to exhibit more rapid development to the next grade in our study. As these findings show, more frequent fundus color photography follow-up in earlier-grade DR patients is important to slow DR progression and awaken self-perception.
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spelling pubmed-84707122021-09-27 The Importance of Close Follow-Up in Patients with Early-Grade Diabetic Retinopathy: A Taiwan Population-Based Study Grading via Deep Learning Model Lee, Chia-Cheng Hsing, Shi-Chue Lin, Yu-Ting Lin, Chin Chen, Jiann-Torng Chen, Yi-Hao Fang, Wen-Hui Int J Environ Res Public Health Article (1) Background: Diabetic retinopathy (DR) can cause blindness. Current guidelines on diabetic eye care recommend more frequent eye examinations for more severe DR to prevent deterioration. However, close follow-up and early intervention at earlier stages are important for the prevention of disease progression of other diabetes mellitus (DM) complications. The study was designed to investigate the association between different stages of DR in type 2 DM patients and the progression of DR; (2) Methods: A total of 2623 type 2 DM patients were included in this study. In these patients, a total of 14,409 fundus color photographs was obtained. The primary outcome was the progression of DR; (3) Results: The progression of DR was highly associated with the initial grade of DR (p < 0.001). Severe nonproliferative diabetic retinopathy (NPDR) was the most likely to progress to proliferative diabetic retinopathy (PDR), followed by moderate NPDR, mild NPDR, and no retinopathy. However, progression to the next stage of DR showed a different trend. We used no retinopathy as a reference. Mild NPDR showed the highest risk for progression to the next stage [hazard ratio (HR): 2.00 (95% conference interval (CI): 1.72–2.32)] relative to higher initial grades [HR (moderate NPDR): 1.82 (95% CI: 1.58–2.09) and HR (severe NPDR): 0.87 (95% CI: 0.69–1.09)]. The same trend was observed in the multivariate analysis, in which mild NPDR presented the highest risk for progression to the next stage (adjusted HR (mild NPDR): 1.95 (95% CI: 1.68–2.27), adjusted HR (moderate NPDR): 1.73 (95% CI: 1.50–1.99), and adjusted HR (severe NPDR): 0.82 (95% CI: 0.65–1.03)); (4) Conclusions: Type 2 diabetic patients with earlier-grade DR appeared to exhibit more rapid development to the next grade in our study. As these findings show, more frequent fundus color photography follow-up in earlier-grade DR patients is important to slow DR progression and awaken self-perception. MDPI 2021-09-16 /pmc/articles/PMC8470712/ /pubmed/34574686 http://dx.doi.org/10.3390/ijerph18189768 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Lee, Chia-Cheng
Hsing, Shi-Chue
Lin, Yu-Ting
Lin, Chin
Chen, Jiann-Torng
Chen, Yi-Hao
Fang, Wen-Hui
The Importance of Close Follow-Up in Patients with Early-Grade Diabetic Retinopathy: A Taiwan Population-Based Study Grading via Deep Learning Model
title The Importance of Close Follow-Up in Patients with Early-Grade Diabetic Retinopathy: A Taiwan Population-Based Study Grading via Deep Learning Model
title_full The Importance of Close Follow-Up in Patients with Early-Grade Diabetic Retinopathy: A Taiwan Population-Based Study Grading via Deep Learning Model
title_fullStr The Importance of Close Follow-Up in Patients with Early-Grade Diabetic Retinopathy: A Taiwan Population-Based Study Grading via Deep Learning Model
title_full_unstemmed The Importance of Close Follow-Up in Patients with Early-Grade Diabetic Retinopathy: A Taiwan Population-Based Study Grading via Deep Learning Model
title_short The Importance of Close Follow-Up in Patients with Early-Grade Diabetic Retinopathy: A Taiwan Population-Based Study Grading via Deep Learning Model
title_sort importance of close follow-up in patients with early-grade diabetic retinopathy: a taiwan population-based study grading via deep learning model
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8470712/
https://www.ncbi.nlm.nih.gov/pubmed/34574686
http://dx.doi.org/10.3390/ijerph18189768
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