ETDRS 5-Year Followup Data Released

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03/09/93

The National Eye Institute reported today that current treatmentsfor a common, sight-threatening complication of diabetes have proved95 percent effective in maintaining vision, but 8,000 still go blindeach 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 isprimarily because of failures to have regular eye examinations so thecondition can be caught before vision is severely damaged.

HHS Secretary Donna E. Shalala said of the report: “Thisfinding underscores the tremendous importance of all people withdiabetes obtaining a dilated eye exam at least once a year to preventvision loss.”

Dr. Ferris, reporting the NEI findings in the Journal of theAmerican Medical Association, said, “The tremendouseffectiveness of current treatment lends even greater urgency tocurrent efforts to ensure that all people with diabetes receiveappropriate treatment.

Diabetic retinopathy causes the slow and often symptomlessdeterioration of blood vessels in the retina, the light-sensitivetissue that lines the inside of the eye and translates light intovisual signals that the brain interprets as vision.

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

About seven million Americans with diabetes have at least earlysigns of diabetic retinopathy, with approximately 65,000 people eachyear progressing to proliferative retinopathy.

Current treatment guidelines call for: (1) regular eye examinationsthrough dilated pupils; (2) timely laser surgery, using a high-energybeam of light to destroy or seal developing retinal blood vesselsbefore they damage vision; and (3) when needed, vitrectomy, a surgicalprocedure that clears hemorrhaged blood from inside the eye that cancloud vision.

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

Previous studies reported that about half of all people who advanceto proliferative retinopathy go blind without treatment within fiveyears.

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

“The finding reported today affirms the important public healthbenefits of clinical research,” said Carl Kupfer, M.D., NEIdirector. “Just one generation ago, eye care professionalsconsidered diabetic retinopathy a baffling and non-treatable disease.Today, thanks to rapid progress in vision research, it is a highlypreventable cause of blindness.”

Since 1978, when laser surgery became a standard treatment fordiabetic retinopathy, tens of thousands of Americans have receivedtimely treatment to save their vision.

In response to the public health issues related to diabeticretinopathy and other blinding eye diseases, the NEI recently launchedthe National Eye Health Education Program (NEHEP) in partnership withover 40 public and private organizations. This nationwide educationand mass media program encourages people with diabetes to have an eyeexamination 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 withdiabetes, as well as those who have other chronic diseases, need to bereminded of the possible complications of the disease and what can bedone about them. The more they hear this message, the more likely theywill be to act upon it.”

Citations

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

June 2001