This study is designed to re-examine a large geographically defined, well characterized cohort of younger and older onset diabetic persons in southwestern Wisconsin in order to determine the lO-year incidence and progression of diabetic retinopathy, macular edema, and visual impairment. Participants will be examined in their home communities in a mobile examining van. As part of the evaluation, refraction, visual acuity, intraocular and blood pressure measurements will be obtained according to standardized protocols. Determination of urine protein and creatinine, blood glycosylated hemoglobin, and plasma C-peptide levels will be performed. Objective recording of retinopathy by use of stereoscopic fundus photography combined with a standardized protocol for grading the retinopathy will be used. Grading of the stereoscopic photographs will provide a sensitive and reproducible method for detection of the new development or progression of retinopathy and macular edema. The incidence and causes of visual impairment will be determined. The incidence of retinopathy and its various component lesions will be evaluated with respect to risk factors such as: duration and age at diagnosis of diabetes, glycosylated hemoglobin level, blood pressure, measures of renal disease, genetic factors, insulin-like growth factors, serum lipids, plasma C-peptide, and other systemic and ocular conditions as ascertained at the previous examination(s). The vital status of participants will be determined to provide data regarding the relationship between severity of retinopathy and other characteristics and prognosis for life. Data from this study will continue to be used for estimating the need for medical counseling and rehabilitative services, for projecting costs, for measuring temporal trends, for developing causal inferences, for developing preventive strategies, and for designing clinical trials.

Agency
National Institute of Health (NIH)
Institute
National Eye Institute (NEI)
Type
Research Project (R01)
Project #
2R01EY003083-11
Application #
3257368
Study Section
Epidemiology and Disease Control Subcommittee 3 (EDC)
Project Start
1979-07-01
Project End
1994-06-30
Budget Start
1989-07-01
Budget End
1990-06-30
Support Year
11
Fiscal Year
1989
Total Cost
Indirect Cost
Name
University of Wisconsin Madison
Department
Type
Schools of Medicine
DUNS #
161202122
City
Madison
State
WI
Country
United States
Zip Code
53715
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Verhoeven, Virginie J M; Hysi, Pirro G; Wojciechowski, Robert et al. (2013) Genome-wide meta-analyses of multiancestry cohorts identify multiple new susceptibility loci for refractive error and myopia. Nat Genet 45:314-8
Grassi, Michael A; Tikhomirov, Anna; Ramalingam, Sudha et al. (2012) Replication analysis for severe diabetic retinopathy. Invest Ophthalmol Vis Sci 53:2377-81
Klein, Barbara E K; Lee, Kristine E; Klein, Ronald (2011) Refraction in adults with diabetes. Arch Ophthalmol 129:56-62
Klein, Ronald; Klein, Barbara E K (2010) Are individuals with diabetes seeing better?: a long-term epidemiological perspective. Diabetes 59:1853-60
Cooper, Rachel; Kuh, Diana; Hardy, Rebecca et al. (2010) Objectively measured physical capability levels and mortality: systematic review and meta-analysis. BMJ 341:c4467
Klein, Ronald; Lee, Kristine E; Gangnon, Ronald E et al. (2010) The 25-year incidence of visual impairment in type 1 diabetes mellitus the wisconsin epidemiologic study of diabetic retinopathy. Ophthalmology 117:63-70
Klein, Ronald; Knudtson, Michael D; Lee, Kristine E et al. (2009) The Wisconsin Epidemiologic Study of Diabetic Retinopathy XXIII: the twenty-five-year incidence of macular edema in persons with type 1 diabetes. Ophthalmology 116:497-503
Klein, Ronald; Lee, Kristine E; Knudtson, Michael D et al. (2009) Changes in visual impairment prevalence by period of diagnosis of diabetes: the Wisconsin Epidemiologic Study of Diabetic Retinopathy. Ophthalmology 116:1937-42
Grassi, Michael A; Mazzulla, D Anthony; Knudtson, Michael D et al. (2009) Patient self-report of prior laser treatment reliably indicates presence of severe diabetic retinopathy. Am J Ophthalmol 147:501-4

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