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  • 1
    ISSN: 1432-0428
    Keywords: Insulin-dependent diabetes ; diabetic retinopathy ; retinal photography ; grading scheme
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary We present the methodology for 45
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-0428
    Keywords: Key words Insulin-dependent-diabetes mellitus ; diabetic nephropathy ; diabetic retinopathy ; blood pressure ; albumin excretion rate.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Several studies have shown an association between blood pressure and nephropathy, but few have been large enough to examine whether, or how, this relation is influenced by retinopathy. We have therefore examined the independent relations of blood pressure to urinary albumin excretion and retinopathy in a cross-sectional observational study of over 3000 insulin-dependent diabetic patients (the EURODIAB IDDM Complications Study). The relation of blood pressure to urinary albumin excretion differed strikingly between patients with (46 %) and without (54 %) retinopathy. In those with retinopathy, mean urinary albumin excretion rate was normal ( 〈 20 μg/min) below median diastolic pressure (75 mm Hg) and increased steeply (p 〈 0.001) with blood pressure above this level. However, in patients without retinopathy, mean albumin excretion rate was normal across the range of diastolic pressure. This finding could not be explained by differences in glycaemic control or duration of diabetes between patients with and without retinopathy. These data identify a subgroup of patients whose high risk of nephropathy may reflect abnormal renal vulnerability to mildly raised blood pressure. Retinopathy is a close correlate of this vulnerability. Detection of even mild retinopathy, together with raised blood pressure, may be important in assessing nephropathy risk. [Diabetologia (1995) 38: 599–603]
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1432-0428
    Keywords: Key words Insulin-dependent diabetes ; diabetic retinopathy ; retinal photography ; grading scheme.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary We present the methodology for 45° retinal photography and detail the development, application and validation of a new system of 45° field grading standards for the assessment of diabetic retinopathy. The systems were developed for the EURODIAB IDDM Complications Study, part of a European Community funded Concerted Action Programme into the epidemiology and prevention of diabetes (EURODIAB). Assessment of diabetic retinopathy was carried out centrally by a trained reader of colour retinal photographs using the newly-developed system. The system proved to be acceptably accurate, repeatable and relatively simple to apply. It compared well with the recognised ’gold standard' 7-field 30° stereo photography (assessed using a modified Airlie House classification scheme), against which the new system was validated in a series of 48 eyes. Selection was as a stratified random sample based on clinical retinopathy status: 5, no retinopathy; 25, non-proliferative retinopathy; 16, proliferative or photocoagulated; plus 2, eyes with potentially confounding lesions (vein occlusion). Simple presence of retinal lesions was correctly detected by both systems in 43 of the 48 eyes, giving 100 % agreement on detection. Both systems correctly identified the two known cases of confounding vein occlusion. In eyes with diabetic retinopathy (n = 41), when severity was expressed in three groups: mild background, moderate/severe background and proliferative/photocoagulated, at least one grader (out of five) using the new system matched the verified results in 38 out of 41 (93 %) eyes and three or more graders matched in 31 (76 %) eyes. Individually the five graders' 2-field allocations agreed well with the verified levels (median number of agreements 37, range 28–43). Repeatability was assessed by measures of within and between observer variation using randomly selected samples of 10 % (n = 252 eyes) and 5 % (n = 123 eyes) of the main study, respectively, expressed as a resultant kappa value for chance-corrected proportional agreement. Within observer assessment yielded a kappa of 0.85 and between observers a value of 0.83; indicating very good agreement for both measures. The method is particularly useful for large epidemiological studies, in which participating centres have a limited experience in retinal photography. [Diabetologia (1995) 38: 437–444]
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1432-0428
    Keywords: Insulin-dependent-diabetes mellitus ; diabetic nephropathy ; diabetic retinopathy ; blood pressure ; albumin excretion rate
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Several studies have shown an association between blood pressure and nephropathy, but few have been large enough to examine whether, or how, this relation is influenced by retinopathy. We have therefore examined the independent relations of blood pressure to urinary albumin excretion and retinopathy in a cross-sectional observational study of over 3000 insulin-dependent diabetic patients (the EURODIAB IDDM Complications Study). The relation of blood pressure to urinary albumin excretion differed strikingly between patients with (46%) and without (54%) retinopathy. In those with retinopathy, mean urinary albumin excretion rate was normal (〈20 Μg/min) below median diastolic pressure (75 mm Hg) and increased steeply (p〈0.001) with blood pressure above this level. However, in patients without retinopathy, mean albumin excretion rate was normal across the range of diastolic pressure. This finding could not be explained by differences in glycaemic control or duration of diabetes between patients with and without retinopathy. These data identify a subgroup of patients whose high risk of nephropathy may reflect abnormal renal vulnerability to mildly raised blood pressure. Retinopathy is a close correlate of this vulnerability. Detection of even mild retinopathy, together with raised blood pressure, may be important in assessing nephropathy risk.
    Type of Medium: Electronic Resource
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
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