Showing papers by "Ronald Klein published in 1987"

The epidemiology of diabetic retinopathy: findings from the Wisconsin Epidemiologic Study of Diabetic Retinopathy.

Abstract: La glycemie et la tension arterielle sont 2 facteurs associes a la presence et a la gravite de la retinopathie diabetique

New management concepts for timely diagnosis of diabetic retinopathy treatable by photocoagulation.

Abstract: Diabetic retinopathy is a leading cause of blindness in the United States. Photocoagulation has been shown to reduce visual loss from macular edema and proliferative retinopathy. Because serious diabetic retinopathy may be asymptomatic and its detection difficult, several recommendations have been made by the National Diabetes Advisory Board for routine ophthalmologic examinations to ensure timely treatment. In geographic areas devoid of ophthalmologists, alternate approaches are necessary. These include intensive training of primary-care physicians in ophthalmoscopy, use of objective recording of retinopathy by fundus photography with interpretation of fundus photographs by retinal specialists, and better communication between primary-care physicians and retinal specialists.

Glycosylated hemoglobin in a population-based study of diabetes.

Abstract: Glycosylated hemoglobin was measured in persons who participated in a population-based study of diabetic retinopathy in southern Wisconsin. There were 996 persons who were diagnosed prior to 30 years of age and who were taking insulin (younger onset), and 1,370 persons who were diagnosed at 30 years of age or older (older onset) who were examined from 1980-1982. Glycosylated hemoglobin was measured using a microcolumn technique. Mean glycosylated hemoglobin was highest in younger onset persons (10.9%), and lowest in older onset persons not taking insulin (9.0%). Only a small percentage of values for the diabetic persons fell within the range of values found in a nondiabetic comparison group. Mean glycosylated hemoglobin was found to be associated with retinopathy status but not with proteinuria.

Accommodative ability in younger-onset diabetes

Abstract: • The relationships among accommodative ability, younger-onset diabetes, and other factors are examined in this report. The study population consists of younger-onset diabetic persons less than 45 years of age who participated in the Wisconsin Epidemiologic Study of Diabetic Retinopathy. In 656 of 859 such persons, near point of accommodation was measured twice for each eye using the best correction for distance visual acuity and a Prince rule. Mean amplitude of accommodation in the diabetic population decreased with age and was less than that of a nondiabetic group and of previously published reports. Other factors associated with decreased accommodation in the diabetic population in a multiple linear regression analysis include sex, with the female population being more susceptible; absence of myopia; a longer duration of diabetes; higher glycosylated hemoglobin level; higher blood glucose level; increasing severity of diabetic retinopathy; and higher systolic blood pressure.

Is Aspirin Use Associated With Lower Rates of Cataracts in Diabetic Individuals

Abstract: The relationship between a history of aspirin use and cataracts in diabetic individuals is examined in this report from a population-based study of 1370 individuals who developed diabetes after 30 yr of age. After pupil dilation lenses were examined for the presence and severity of nuclear sclerotic and posterior subcapsular cataracts and for surgical aphakia. A history of aspirin usage was obtained. Seven hundred eighty-four individuals had used aspirin in the month before the exam. There was no relationship between such usage and cataracts. For 338 people who reported using aspirin daily for at least 3 mo while having diabetes, there was also no association. These data suggest that aspirin usage as measured here has little effect on the prevalence of cataract in older-onset diabetic patients.

Longitudinal measure of glycemic control and diabetic retinopathy.

Abstract: In a population-based study, 5431 diabetic people in southern Wisconsin who were mature at onset of diabetes were identified, and their charts were reviewed. Recent glycemic control was evaluated from these charts. An index of recent glucose control with at least three glucose determinations abstracted from the doctor9s chart was constructed. A sample of 1370 of the 5431 individuals was examined as part of this study. An index of glucose control could be derived for 568 of 674 people using insulin and for 565 of 696 nonusers of insulin. Correlation of the index with the glycosylated hemoglobin obtained at the time of study was significant in insulin users and nonusers.

Is Aspirin Usage Associated With Diabetic Retinopathy

Abstract: The relationship between the history of aspirin usage and diabetic retinopathy is examined in this report. The study population consists of a sample of people (n = 1370) who developed diabetes mellitus after 30 yr of age, who lived in south-central Wisconsin, and who participated in the Wisconsin Epidemiologic Study of Diabetic Retinopathy. These participants were questioned about recent and past use of aspirin. There was no association between the number of aspirin used in the month before the exam and the severity of diabetic retinopathy. Three hundred thirty-eight of these individuals reported taking aspirin daily for at least 3 mo since they were diagnosed as having diabetes. There was no association between the severity of retinopathy and having used aspirin in this way. These analyses suggest that aspirin usage, as herein described, is unrelated to the severity of diabetic retinopathy in older-onset diabetic patients.