Predicting progression to severe proliferative diabetic retinopathy
G. H. Bresnick and M. Palta
The longer-term progression of retinopathy was observed in a previously
described group of 85 diabetic patients enrolled in the Early Treatment
Diabetic Retinopathy Study. The probability of progression to severe
retinopathy was significantly greater for eyes with the following baseline
characteristics: greater overall retinopathy severity, higher fluorescein
leakage, higher capillary nonperfusion, and lower electroretinographic
oscillatory potential amplitudes. The summed amplitudes of the oscillatory
potentials, the overall severity of retinopathy, and the severity of
fluorescein angiographic leakage were found to be independent predictors of
progression to severe proliferative retinopathy in a regression model;
capillary nonperfusion was not found to predict progression independently
when fluorescein leakage was included in the model. Probability curves
based on the regression model can be used to support clinical decisions
concerning when to perform panretinal laser photocoagulation and how often
to follow up patients with less than severe proliferative diabetic
retinopathy.
