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Maculopathy and visual acuity in newly diagnosed type 2 diabetic patients and non-diabetic subjects: a 10-year follow-up study.

PURPOSE
The long-term evolution of diabetic maculopathy and visual acuity and their risk factors in patients with newly diagnosed Type 2 diabetes and in control subjects.


METHODS
A 10-year prospective study consisting of a representative group of 133 (70 men, 63 women) newly diagnosed Type 2 diabetic patients diagnosed at health centers between 1979 and 1981 and 144 (62 men, 82 women) non-diabetic control subjects recruited from the population register. The frequency of maculopathy was determined by grading of 45 degrees fundus photographs and fluorescein angiograms. The subjects were studied at baseline and after 5 and 10 years.


RESULTS
The frequency of maculopathy in Type 2 diabetic patients was low at the time of diagnosis but increased sharply after 5 years of the disease and at the 10-year examination 21% of diabetic patients had signs of maculopathy. By the 10-year follow-up the visual acuity declined more markedly in the diabetic patients than in the control subjects. Poor glycaemic control was the most important predictive factor for the development of maculopathy as well as deterioration of visual acuity.


CONCLUSIONS
In newly diagnosed patients with Type 2 diabetes one-fifth had developed maculopathy which deteriorated their visual acuity. Poor glycaemic control was the most important predictor of maculopathy.