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- Jakobsson, Peter, 1947-, et al.
(författare)
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The frequency of amblyopia among visually impaired persons
- 2002
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Ingår i: Acta Ophthalmologica Scandinavica. - : Wiley. - 1395-3907 .- 1600-0420. ; 80:1, s. 44-46
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To investigate the frequency of amblyopia among visually handicapped patients.Methods: The study is a retrospective investigation of all living patients registered in four Visual Rehabilitation Centres in a region in southern Sweden. The area's total population numbered 865,612 persons of whom 11,365 were registered as visually handicapped (with visual acuity ≤ 0.3 in the better eye).Results: Amblyopia was the main cause of decreased visual acuity in one eye in 1.72% (195 of 11,365) of the patients. The average age of the patients with amblyopia was 69 years (9−95 years) and 28.2% of these patients were less than 65 years old (the age for retirement in Sweden).The median visual acuity in the amblyopic eye among these patients was 0.1. The median visual acuity in the nonamblyopic eye was 0.2. The most common cause of decreased vision in the nonamblyopic eye was macular degeneration (39.5%). Bilateral amblyopia was present in 13 (6.7%) of the amblyopic patients. By comparing this study with earlier studies, we can calculate that about 1.2% of the persons with amblyopia 0.3 or lower will eventually become visually handicapped.Conclusion: A small but considerable number of patients who attend the Visual Rehabilitation Centres have amblyopia as a cause of their visual impairment. Since amblyopia can be treated if detected in childhood, later visual rehabilitation of these patients can be avoided or delayed, thereby reducing rehabilition costs for society.
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| 2. |
- Nordwall, Maria, et al.
(författare)
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Comment: Response to Comment on Nordwall et al. Impact of HbA1c, Followed From Onset of Type 1 Diabetes, on the Development of Severe Retinopathy and Nephropathy: The VISS Study (Vascular Diabetic Complications in Southeast Sweden). Diabetes Care 2015;38:308-315
- 2015
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Ingår i: Diabetes Care. - : American Diabetes Association. - 0149-5992 .- 1935-5548. ; 38:8, s. e124-
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- We thank Dr. Takahara (1) for the comment on our recent article exploring the impact of HbA1c, followed from diabetes onset, on the development of severe microvascular complications (2). As suggested, we have validated our results with Cox hazards analysis with severe microvascular events, i.e., laser-treated proliferative retinopathy and macroalbuminuria as a dependent variable and HbA1c (mmol/mol) as a time-dependent covariate.For laser-treated proliferative retinopathy, we found a hazard ratio of 1.038 (95% CI 1.025–1.052, P < 0.001) and for macroalbuminuria, a hazard ratio of 1.075 (95% CI 1.050–1.100, P < 0.001).Analyzing our data with Cox hazards analysis thus shows the strong influence of long-term HbA1c on severe microvascular complications, in agreement with our previous conclusions.In our article, we chose to analyze and present the results in a way that was perhaps easier for a clinician to interpret and apply in clinical routine. With life-table analysis we found that the incidence of both laser-treated proliferative retinopathy and macroalbuminuria increased sharply and occurred earlier with increasing long-term weighted mean HbA1c. In the same manner, the prevalence of microvascular complications increased steeply with higher long-term weighted mean HbA1c, categorized in different groups.In conclusion, our study irrespective of statistical methods shows a strong association between development of late complications and long-term mean HbA1c, and keeping the average HbA1c below 7.6% (60 mmol/mol) seemed sufficient to prevent microvascular complications for at least up to 20 years.
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| 3. |
- Nordwall, Maria, et al.
(författare)
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Impact of HbA(1c), Followed From Onset of Type 1 Diabetes, on the Development of Severe Retinopathy and Nephropathy: The VISS Study (Vascular Diabetic Complications in Southeast Sweden)
- 2015
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Ingår i: Diabetes Care. - : American Diabetes Association. - 0149-5992 .- 1935-5548. ; 38:2, s. 308-315
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVEHbA(1c) is strongly related to the development of diabetes complications, but it is still controversial which HbA(1c) level to strive for in the treatment of type 1 diabetes. The aim of the current study was to evaluate HbA(1c), followed from diagnosis, as a predictor of severe microvascular complications and to formulate HbA(1c) target levels for treatment.RESEARCH DESIGN AND METHODSA longitudinal observation study followed an unselected population of 451 patients diagnosed with type 1 diabetes during 1983-1987 before the age of 35 years in a region of Southeast Sweden. Retinopathy was evaluated by fundus photography and nephropathy data collected from medical records. HbA(1c) was measured starting from diagnosis and during the whole follow-up period of 20-24 years. Long-term weighted mean HbA(1c) was then calculated. Complications were analyzed in relation to HbA(1c) levels.RESULTSThe incidence of proliferative retinopathy and persistent macroalbuminuria increased sharply and occurred earlier with increasing long-term mean HbA(1c). None of the 451 patients developed proliferative retinopathy or persistent macroalbuminuria below long-term weighted mean HbA(1c) 7.6% (60 mmol/mol); 51% of the patients with long-term mean HbA(1c) above 9.5% (80 mmol/mol) developed proliferative retinopathy and 23% persistent macroalbuminuria.CONCLUSIONSLong-term weighted mean HbA(1c), measured from diagnosis, is closely associated with the development of severe complications in type 1 diabetes. Keeping HbA(1c) below 7.6% (60 mmol/mol) as a treatment target seems to prevent proliferative retinopathy and persistent macroalbuminuria for up to 20 years.
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