Aims/Introduction. To investigate whether the occurrence of early worsening of diabetic retinopathy in patients with type 2 diabetes diagnosed with simple or preproliferative diabetic retinopathy at their first visit differed according to HbA1c reduction and/or treatment intensification. Materials and Methods. Our study design was a retrospective observational study. Subjects with type 2 diabetes diagnosed with either simple or preproliferative diabetic retinopathy by ophthalmologists at their first visit and followed up for 6–18 months thereafter were included and divided into worsening and nonworsening groups. Thereafter, baseline characteristics and changes in HbA1c and therapy over a year were investigated. Results. Among the 88 subjects with simple diabetic retinopathy, 16% improved to no retinopathy, 65% retained their simple diabetic retinopathy, 18% worsened to preproliferative diabetic retinopathy, and 1% worsened to proliferative diabetic retinopathy. Among the 47 subjects with preproliferative diabetic retinopathy, 9% improved to simple diabetic retinopathy, 72% retained their preproliferative diabetic retinopathy, and 19% worsened to proliferative diabetic retinopathy. Patients with simple diabetic retinopathy had an odds ratio of 1.44 for worsening retinopathy with a 1% increase in baseline HbA1c. Meanwhile, the odds ratios for worsening retinopathy with a 1% decrease in HbA1c from baseline at 3, 6, and 12 months were 1.34, 1.31, and 1.38, respectively. Among patients with simple diabetic retinopathy, significantly more new interventions were introduced in the worsening group than in the nonworsening group. Conclusions. Increased baseline HbA1c, a substantial decrease in HbA1c, and intensified therapy were identified as risk factors for early worsening of diabetic retinopathy in patients with simple diabetic retinopathy at the first visit. Patients should therefore be intimately followed for retinopathy after their first visit.

中文翻译：

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与首次就诊时诊断为视网膜病变的 2 型糖尿病患者视网膜病变早期恶化相关的特征：一项回顾性观察研究

目标/介绍。调查第一次就诊时诊断为单纯性或增殖性糖尿病性视网膜病变的 2 型糖尿病患者的糖尿病性视网膜病变早期恶化的发生率是否因 HbA1c 降低和/或治疗强化而不同。材料和方法。我们的研究设计是一项回顾性观察研究。2 型糖尿病患者在首次就诊时被眼科医生诊断为单纯性或增殖性糖尿病视网膜病变，随后随访 6-18 个月，并分为恶化组和非恶化组。此后，调查了一年中 HbA1c 和治疗的基线特征和变化。结果. 在 88 名患有单纯性糖尿病视网膜病变的受试者中，16% 改善至无视网膜病变，65% 保留其单纯性糖尿病视网膜病变，18% 恶化为增殖前糖尿病视网膜病变，1% 恶化为增殖性糖尿病视网膜病变。在 47 名患有增殖前糖尿病视网膜病变的受试者中，9% 改善为单纯性糖尿病视网膜病变，72% 保留了增殖前糖尿病视网膜病变，19% 恶化为增殖性糖尿病视网膜病变。单纯性糖尿病视网膜病变患者视网膜病变恶化的优势比为 1.44，基线 HbA1c 增加 1%。同时，在 3、6 和 12 个月时，视网膜病变恶化与 HbA1c 较基线下降 1% 的优势比分别为 1.34、1.31 和 1.38。在单纯性糖尿病视网膜病变患者中，结论。基线 HbA1c 升高、HbA1c 大幅下降和强化治疗被确定为首次就诊时单纯性糖尿病视网膜病变患者糖尿病视网膜病变早期恶化的危险因素。因此，应在首次就诊后密切跟踪患者的视网膜病变。