“We want to fight blindness any way we can. We want to prevent it, treat it, and cure it,” said Charles C. Wykoff, MD, during the IRIS Registry Symposium on Sunday. He explained how he used data from the world’s largest specialty clinical data registry to identify risk factors associated with developing sustained blindness in diabetic retinopathy (DR).
A major public health issue. An estimated 8% of the global population was affected by diabetes in 2016, up significantly from the 2.8% recorded in the 1990s. Accordingly, DR remains a leading cause of blindness in adults.
With DR expected to affect 14 million people in the United States by 2050, is there a way for physicians to stratify which of these patients are at higher risk for developing sustained blindness?
IRIS Registry to the rescue. Researchers mined through 5 years of IRIS Registry data—excluding those patients with a history of retinal diseases—and identified 53,535 newly diagnosed DR patients with good vision at baseline. Of these, 678 progressed to blindness during follow-up.
The study’s main objectives were to identify baseline or follow-up risk factors for developing sustained blindness. Investigators defined sustained blindness as at least two readings of 20/200 or worse more than 3 months apart, or no improvement beyond 20/100 after the first 20/200 reading.
Baseline risk factors. After adjusting for covariates, the analysis revealed 2 significant baseline risk factors. Eyes with proliferative DR (PDR) or severe nonproliferative DR were 4 and 3.6 times more likely, respectively, to develop blindness compared with eyes with mild DR.
Follow-up risk factors. Seven risk factors were identified for progression to blindness during follow-up. Development of vitreous hemorrhage during follow-up emerged as the most significant risk factor (hazard ratio, 9.4). Other risk factors for blindness included the development of glaucoma, age-related macular degeneration, retinal vein occlusion, diabetic macular edema, retinal detachment, and PDR.
Armed with this data, physicians can now identify which patients may benefit from closer monitoring and/or earlier intervention. “The IRIS registry provides an incredibly rich dataset to better understand eye diseases,” Dr. Wykoff concluded. —Keng Jin Lee
Financial disclosures. Alcon Laboratories, Inc.: C,S; Alimera Sciences, Inc.: C; Allegro Ophthalmics: S; Allergan: C,L,S; Alnylam Pharmaceuticals: C; Apellis Pharmaceuticals: S; Aura Biosciences, Inc.: S; Bayer Healthcare Pharmaceuticals: C; Clearside Biomedical, Inc: C,S; Dutch Ophthalmic Research Center International: C; Genentech: C,S; Iconic Therapeutics: S,C; National Eye Institute: S; National Institutes of Health: S; Novartis Pharmaceuticals Corporation: S; OHR Pharmaceuticals: S; ONL Therapeutic: C; Ophthotech Corporation: S; pSivida Corp: S; Regeneron Pharmaceuticals, Inc.: C,L,S; Roche: S; Santen, Inc.: S; SciFluor Life Sciences, LLC: S; ThromboGenics, Inc.: C; Tyrogenex: S; Valeant: C.
Disclosure key. C = Consultant/Advisor; E = Employee; L = Speakers bureau; O = Equity owner; P = Patents/Royalty; S = Grant support.
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