糖尿病網膜症の5年良性化率

A five-year follow-up study of diabetic retinopathy

　1988年に初診した糖尿病患者231例（460眼）を対象に網膜症各病期の5年経過を調査し，網膜症の初診時有症率，5年後発症率，5年良性化率および各病期の経時的比率について検討した。初診時網膜症（福田分類）の頻度はO群64.6％，A群23.7％，B群11.7％で，初診時有症率は35.4％，5年後発症率は18.2％であった。網膜症5年間の経時的推移では，初診時O群ではA,B群へ移行する比率が直線的に増加，初診時A群では初診後2年までB群の比率が増えた後再び減っていた。初診時B群では徐々にA群の比率が増加し，眼科的治療による5年良性化率（B→A群）は77.8％であった。これらの比率は，網膜症の適切な管理を行うための1指標になると思われた。

A five-year retrospective study was performed from 1988 on 231 diabetic patients to investigate the prior and 5-year incidence and prevalence of each stage of diabetic retinopathy (DR) and rate of improvement of proliferative retinopathy achieved by photocoagulation and/or vitrectomy. The initial prevalence of retinopathy was 64.6% in group O (no DR), 23.7% in group A (benign DR) and 11.7% in group B (malignant DR) according to Fukuda's classification. The 5-year DR incidence was 18.2% and the rate of improvement from group B to A was 77.8%. During the 5-year follow-up period the numbers in both group A and group B were increased by patients from group O ; and the number in group B was increased gradually by patients from group A for the first 2 years and then decreased, probably because of the ophthalmologic treatment. These results suggest that it is imperative for patients to be screened for any possible need for ophthalmologic treatment, and may be an important therapeutic guideline for cases of diabetic retinopathy.