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ETDRS 5-Year Followup Data Released

March 9, 1993
NEI

The National Eye Institute reported today that current treatments for a common, sight-threatening complication of diabetes have proved95 percent effective in maintaining vision, but 8,000 still go blind each year from this disease.

Reporting in the Journal of the American Medical Association, Frederick Ferris III, M.D., chief of NEI’s clinical trials branch, said the continuing loss of sight from diabetic retinopathy is primarily because of failures to have regular eye examinations so the condition can be caught before vision is severely damaged.

HHS Secretary Donna E. Shalala said of the report: “This finding underscores the tremendous importance of all people with diabetes obtaining a dilated eye exam at least once a year to prevent vision loss.”

Dr. Ferris, reporting the NEI findings in the Journal of the American Medical Association, said, “The tremendous effectiveness of current treatment lends even greater urgency to current efforts to ensure that all people with diabetes receive appropriate treatment.

Diabetic retinopathy causes the slow and often symptomless deterioration of blood vessels in the retina, the light-sensitive tissue that lines the inside of the eye and translates light into visual signals that the brain interprets as vision.

As the disease progresses to the proliferative stage, its most sight-threatening phase, new and extremely fragile blood vessels begin to multiply and grow toward the center of the eye, leading to hemorrhaging within the eye, retinal detachment, and blindness.

About seven million Americans with diabetes have at least early signs of diabetic retinopathy, with approximately 65,000 people each year progressing to proliferative retinopathy.

Current treatment guidelines call for: (1) regular eye examinations through dilated pupils; (2) timely laser surgery, using a high-energy beam of light to destroy or seal developing retinal blood vessels before they damage vision; and (3) when needed, vitrectomy, a surgical procedure that clears hemorrhaged blood from inside the eye that can cloud vision.

Today’s published findings, based on an analysis of five-year follow-up data from the Early Treatment of Diabetic Retinopathy Study, showed that with appropriate treatment even people with proliferative diabetic retinopathy have a 95 percent chance of maintaining vision of20/200 or better for at least five years. A person whose best-corrected vision is 20/200 (meaning this person sees at 20 feet what a person with perfect vision sees at 200 feet) or worse in the better eye is considered legally blind.

Previous studies reported that about half of all people who advance to proliferative retinopathy go blind without treatment within five years.

The study, which was begun in the late 1970s, is a large, NEI-supported clinical trial that has been instrumental in establishing current treatment guidelines for the disease.

“The finding reported today affirms the important public health benefits of clinical research,” said Carl Kupfer, M.D., NEI director. “Just one generation ago, eye care professionals considered diabetic retinopathy a baffling and non-treatable disease. Today, thanks to rapid progress in vision research, it is a highly preventable cause of blindness.”

Since 1978, when laser surgery became a standard treatment for diabetic retinopathy, tens of thousands of Americans have received timely treatment to save their vision.

In response to the public health issues related to diabetic retinopathy and other blinding eye diseases, the NEI recently launched the National Eye Health Education Program (NEHEP) in partnership with over 40 public and private organizations. This nationwide education and mass media program encourages people with diabetes to have an eye examination through dilated pupils at least once a year.

“It’s clear that nobody wants to lose their vision,” said Judith Stein, NEHEP director. “But we know that people with diabetes, as well as those who have other chronic diseases, need to be reminded of the possible complications of the disease and what can be done about them. The more they hear this message, the more likely they will be to act upon it.”

Citations

  • Ferris FL 3rd. How Effective Are Treatments for Diabetic Retinopathy? JAMA. 1993 March 10. PubMed