Prevalence and Significance of Retinopathy in Subjects With Type 1 Diabetes of Less Than 5 Years’ Duration Screened for the Diabetes Control and Complications Trial

OBJECTIVE —The Diabetes Control and Complications Trial (DCCT) demonstrated the powerful impact of glycemic control on the progression of diabetic retinopathy. A large number of individuals (2,771) underwent stereoscopic color photography and fluorescein angiography as part of screening for participation in the DCCT. A subgroup of those individuals screened participated in the DCCT and underwent evaluation of their retinal vasculature semiannually for 4–9 years. These data were evaluated to determine how the 2000 American Diabetes Association position statement would apply to the DCCT experience. Specifically, the position statement indicates that the first dilated eye examination should be performed after 3–5 years’ duration of diabetes because vision-threatening retinopathy virtually never develops in patients with type 1 diabetes during that interval. RESEARCH DESIGN AND METHODS —We examined the experience of the DCCT in evaluating retinal photographs in 1,613 patients with type 1 diabetes of RESULTS —Of 1,613 subjects with type 1 diabetes of CONCLUSIONS —Dilated eye examinations and retinal photography should be included in the routine management of type 1 diabetes during the first 5 years to identify the individuals at greatest risk for vision-threatening problems.