Abstract
Diabetic retinopathy is known to be the leading cause of acquired blindness. We investigated the prevalence, causes, clinical characteristics and prognosis of blind subjects in 615 non-insulin dependent diabetes mellitus (NIDDM) patients.
The prevalence of binocular blindness and severe visual impairment was 4%(n=24) and 8%(n=51), respectively. Among the groups with visual impairment, which had a significantly longer duration, younger start and higher percentage of insulin treatment of diabetes than the group with good visual acuity, the blind group had the longest duration, the youngest start and the highest percentage of insulin treatment. The serum levels of HDL-cholesterol tended to be lowest.
Fourteen (58%) of the 24 blind subjects were on hemodialysis because of renal failure.The chief causes of blindness were: vitreous hemorrhage, retinal detachment, maculopathy, neovascular glaucoma, and/or cataract. Multiple regression analysis established aging, proliferative retinopathy, cataract, nephropathy, insulin therapy, and duration of diabetes as independent risk factors for visual impairment.Although there was no significant correlation between plasma glucose levels and blindness, probably because this study was cross-sectional, the patients'historyrevealed thatprevious control of diabetes had been very poor in the blind subjects. The high mortality rate of the blind subjects (245/1000 person-year) during the short observation period indicates that the life prognosis of blind diabetic subjects is very poor.
