EDITORIAL Predicting Risk of Diabetic Retinopathy From Retinal Vessel Analysis Personalized Medicine in Transition ESPITE SIGNIFICANT ADVANCES IN THERA- deserves discussion. Although increasing caliber of ar- peutic strategies, diabetic retinopathy re- terioles appeared to be modestly associated with reti- mains a leading cause of preventable vi- nopathy incidence and progression, these associations did sion loss among working-aged people in not reach statistical significance. This is a somewhat un- D many developed countries. In the United expected finding as several prospective studies, includ- States, about 1 in 4 diabetic patients has signs of retinopa- ing an earlier report from the WESDR, have previously thy and 1 in 20 has vision-threatening retinopathy. Be- demonstrated a positive association between larger reti- cause early treatment is associated with better outcomes, nal arteriolar caliber at baseline and incident retinopa- 8,9 clinicians routinely try to estimate a patient’s risk of visual thy in patients with type 1 and type 2 diabetes. In ad- morbidity from diabetic retinopathy based on traditional dition, experimental studies offer good evidence that risk factors (eg, diabetes duration, glycemic control, and retinal arteriolar dilatation is an early physiological in- blood pressure control) and retinopathy severity. dicator of impaired arteriolar autoregulation related
JAMA Ophthalmology – American Medical Association
Published: Jun 1, 2012
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