Treatment of diabetic retinopathy

New England Journal of Medicine

Volumn 341, Issue 9, 1999, Pages 667-678

  Ferris III, Frederick L ^a,d   Davis, Matthew D ^b   Aiello, Lloyd M ^c  

^a NATIONAL EYE INSTITUTE   (United States)

^b UNIVERSITY OF WISCONSIN SCHOOL OF MEDICINE AND PUBLIC HEALTH   (United States)

^c JOSLIN DIABETES CENTER   (United States)

^d Division of Epidemiology   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ACETYLSALICYLIC ACID;

BLINDNESS; BLOOD VESSEL OCCLUSION; CLINICAL FEATURE; DIABETIC RETINOPATHY; LASER COAGULATION; MICROANEURYSM; NEOVASCULARIZATION (PATHOLOGY); PRIORITY JOURNAL; RETINA MACULA EDEMA; REVIEW; VITRECTOMY;

DIABETES MELLITUS, TYPE 1; DIABETIC RETINOPATHY; HUMANS; HYPOGLYCEMIC AGENTS; LIGHT COAGULATION; VITRECTOMY;

EID: 0033606913     PISSN: 00284793     EISSN: None     Source Type: Journal    
DOI: 10.1056/NEJM199908263410907     Document Type: Review

References (128)

1. Kahn HA, Hiller R. Blindness caused by diabetic retinopathy. Am J Ophthalmol 1974;78:58-67.
2. Kahn HA, Bradley RF. Prevalence of diabetic retinopathy: age, sex, and duration of diabetes. Br J Ophthalmol 1975;59:345-9.
3. Klein R, Klein BE, Moss SE. The Wisconsin Epidemiologic Study of Diabetic Retinopathy: a review. Diabetes Metab Rev 1989;5:559-70.
4. Klein BEK, Klein R, Wang Q, Moss SE. Older-onset diabetes and lens opacities: the Beaver Dam Eye Study. Ophthalmic Epidemiol 1995;2:49-55.
5. Klein BEK, Klein R, Moss SE. Prevalence of cataracts in a population-based study of persons with diabetes mellitus. Ophthalmology 1985;92: 1191-6.
6. Idem. Incidence of cataract surgery in the Wisconsin Epidemiologic Study of Diabetic Retinopathy. Am J Ophthalmol 1995;119:295-300.
7. Klein BEK, Klein R, Jensen SC. Open-angle glaucoma and older-onset diabetes: the Beaver Dam Eye Study. Ophthalmology 1994;101:1173-7.
8. Klein BEK, Klein R, Moss SE. Intraocular pressure in diabetic persons. Ophthalmology 1984;91:1356-60.
9. The Diabetes Control and Complications Trial Research Group. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med 1993;329:977-86.
10. Beetham WP. Visual prognosis of proliferating diabetic retinopathy. Br J Ophthalmol 1963;47:611-9.
11. Caird FI, Burditt AF, Draper GJ. Diabetic retinopathy: a further study of prognosis for vision. Diabetes 1968;17:121-3.
12. Deckert T, Simonsen SE, Poulsen JE. Prognosis of proliferative retinopathy in juvenile diabetes. Diabetes 1967;16:728-33.
13. Ferris FL III. How effective are treatments for diabetic retinopathy? JAMA 1993;269:1290-1.
14. Larson H-W. Diabetic retinopathy: an ophthalmoscopic study with a discussion of the morphologic changes and the pathogenetic factors in this disease. Acta Ophthalmol Scand Suppl 1960;60:1-89.
15. Dobree JH. Proliferative diabetic retinopathy: evolution of the retinal lesions. Br J Ophthalmol 1964;48:637-49.
16. Davis MD. Vitreous contraction in proliferative diabetic retinopathy. Arch Ophthalmol 1965;74:741-51.
17. Tolentino FI, Lee PF, Schepens CL. Biomicroscopic study of vitreous cavity in diabetic retinopathy. Arch Ophthalmol 1966;75:238-46.
18. Davis MD. The natural course of diabetic retinopathy. In: Kimura SJ, Caygill WM, eds. Vascular complications of diabetes mellitus: with special emphasis on microangiopathy of the eye. St. Louis: C.V. Mosby, 1967:139-69.
19. Goldberg MF, Fine SL, eds. Symposium on the treatment of diabetic retinopathy. Washington, D.C.: Government Printing Office, 1969. (USPHS publication no. 1890.)
20. Davis MD, Kern TS, Rand LI. Diabetic retinopathy. In: Alberti KGMM, Zimmet P, DeFronzo RA, eds. International textbook of diabetes mellitus. 2nd ed. Vol. 2. Chichester, England: John Wiley, 1997:1413-46.
21. Kuwabara T, Cogan DG. Studies of retinal vascular patterns. I. Normal architecture. Arch Ophthalmol 1960;64:904-11.
22. Engerman RL. Pathogenesis of diabetic retinopathy. Diabetes 1989; 38:1203-6.
23. Engerman RL, Kern TS. Experimental galactosemia produces diabetic-like retinopathy. Diabetes 1984;33:97-100.
24. Kador PF, Akagi Y, Terubayashi Y, Wyman M, Kinoshita JH. Prevention of pericyte ghost formation in retinal capillaries of galactose-fed dogs by aldose reductase inhibitors. Arch Ophthalmol 1988;106:1099-102.
25. Robison WG Jr, Nagata M, Laver N, Hohman TC, Kinoshita JH. Diabetic-like retinopathy in rats prevented with an aldose reductase inhibitor. Invest Ophthalmol Vis Sci 1989;30:2285-92.
26. Wise GN. Retinal neovascularization. Trans Am Ophthalmol Soc 1956;54:729-826.
27. Cogan DG, Toussaint D, Kuwabara T. Retinal vascular patterns. IV. Diabetic retinopathy. Arch Ophthalmol 1961;66:366-78.
28. Frank RN. Etiologic mechanisms in diabetic retinopathy. In: Schachat AP, Murphy RB, Patz A, eds. Medical retina. Vol. 2 of Retina. St. Louis: C.V. Mosby, 1989:301-26.
29. Kohner EM, Sleightholm M. Does microaneurysm count reflect severity of early diabetic retinopathy? Ophthalmology 1986;93:586-9.
30. Klein R, Meuer SM, Moss SE, Klein BEK. The relationship of retinal microaneurysm counts to the 4-year progression of diabetic retinopathy. Arch Ophthalmol 1989;107:1780-5.
31. Idem. Retinal microaneurysm counts and 10-year progression of diabetic retinopathy. Arch Ophthalmol 1995;113:1386-91.
32. Patz A, Schatz H, Berkow JW, Gittelsohn AM, Ticho U. Macular edema - an overlooked complication of diabetic retinopathy. Trans Am Acad Ophthalmol Otolaryngol 1973;77:OP-34-OP-42.
33. Ferris FL III, Patz A. Macular edema: a complication of diabetic retinopathy. Surv Ophthalmol 1984;28:Suppl:452-61.
34. King RC, Dobree JH, Kok D-A, Foulds WS, Dangerfield WG. Exudative diabetic retinopathy: spontaneous changes and effects of a corn oil diet. Br J Ophthalmol 1963;47:666-72.
35. Sigurdsson R, Begg IS. Organised macular plaques in exudative diabetic maculopathy. Br J Ophthalmol 1980;64:392-7.
36. Klein BEK, Moss SE, Klein R, Surawicz TS. The Wisconsin Epidemiologic Study of Diabetic Retinopathy. XIII. Relationship of serum cholesterol to retinopathy and hard exudate. Ophthalmology 1991;98:1261-5.
37. Chew EY, Klein ML, Ferris FL III, et al. Association of elevated serum lipid levels with retinal hard exudate in diabetic retinopathy: Early Treatment Diabetic Retinopathy Study (ETDRS) report 22. Arch Ophthalmol 1996;114:1079-84.
38. Early Treatment Diabetic Retinopathy Study Research Group. Fundus photographic risk factors for progression of diabetic retinopathy: ETDRS report number 12. Ophthalmology 1991;98:Suppl:823-33.
39. The Diabetic Retinopathy Study Research Group. Photocoagulation treatment of proliferative diabetic retinopathy: the second report of Diabetic Retinopathy Study findings. Ophthalmology 1978;85:82-106.
40. British Multicenter Study Group. Photocoagulation for proliferative diabetic retinopathy: a randomised controlled clinical trial using the xenonarc. Diabetologia 1984;26:109-15.
41. Rand LI, Prud'homme GJ, Ederer F, Canner PL, Diabetic Retinopathy Study Research Group. Factors influencing the development of visual loss in advanced diabetic retinopathy: Diabetic Retinopathy Study (DRS) report no. 10. Invest Ophthalmol Vis Sci 1985;26:983-91.
42. Diabetic Retinopathy Study Research Group. Report 7: a modification of the Airlie House classification of diabetic retinopathy. Invest Ophthalmol Vis Sci 1981;21:210-26.
43. Early Treatment Diabetic Retinopathy Research Group. Grading diabetic retinopathy from stereoscopic color fundus photographs: an extension of the modified Airlie House classification. ETDRS report number 10. Ophthalmology 1991;98:Suppl:786-806.
44. Tasman W. Diabetic virtreous hemorrhage and its relationship to hypoglycemia. Mod Probl Ophthalmol 1979;20:413-4.
45. Anderson B Jr. Activity and diabetic vitreous hemorrhages. Ophthalmology 1980;87:173-5.
46. Klein R, Klein BEK, Moss SE, Davis MD, DeMets DL. The Wisconsin Epidemiologic Study of Diabetic Retinopathy. II. Prevalence and risk of diabetic retinopathy when age at diagnosis is less than 30 years. Arch Ophthalmol 1984;102:520-6.
47. Idem. The Wisconsin Epidemiologic Study of Diabetic Retinopathy. III. Prevalence and risk of diabetic retinopathy when age at diagnosis is 30 or more years. Arch Ophthalmol 1984;102:527-32.
48. Idem. Glycosylated hemoglobin predicts the incidence and progression of diabetic retinopathy. JAMA 1988;260:2864-71.
49. The DCCT Research Group. The Diabetes Control and Complications Trial (DCCT): design and methodologic considerations for the feasibility phase. Diabetes 1986;35:530-45.
50. The Diabetes Control and Complications Trial (DCCT) Research Group. Effect of intensive therapy on the development and progression of diabetic nephropathy in the Diabetes Control and Complications Trial. Kidney Int 1995;47:1703-20.
51. Idem. Effect of intensive diabetes treatment on nerve conduction in the Diabetes Control and Complications Trial. Ann Neurol 1995;38:869-80.
52. Reichard P, Nilsson B-Y, Rosenqvist U. The effect of long-term intensified insulin treatment on the development of microvascular complications of diabetes mellitus. N Engl J Med 1993;329:304-9.
53. Klein R, Klein BE, Moss SE. Relation of glycemic control to diabetic microvascular complications in diabetes mellitus. Ann Intern Med 1996; 124:90-6.
54. Ohkubo Y, Kishikawa H, Araki E, et al. Intensive insulin therapy prevents the progression of diabetic microvascular complications in Japanese patients with non-insulin-dependent diabetes mellitus: a randomized prospective 6-year study. Diabetes Res Clin Pract 1995;28:103-17.
55. UK Prospective Diabetes Study (UKPDS) Group. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet 1998;352:837-53.
56. Idem. Effect of intensive blood-glucose control with metformin on complications in overweight patients with type 2 diabetes (UKPDS 34). Lancet 1998;352:854-65. [Erratum, Lancet 1998;352:1557]
57. Dahl-Jorgensen K, Brinchmann-Hansen O, Hanssen KF, Sandvik L, Aagenacs O. Rapid tightening of blood glucose control leads to transient deterioration of retinopathy in insulin dependent diabetes mellitus: the Oslo study. BMJ 1985;290:811-5.
58. Daneman D, Drash AL, Lobes LA, Becker DJ, Baker LM, Travis LB. Progressive retinopathy with improved control in diabetic dwarfism (Mauriac's syndrome). Diabetes Care 1981;4:360-5.
59. Puklin JE, Tamborlane WV, Felig P, Genel M, Sherwin RS. Influence of long-term insulin infusion pump treatment of type 1 diabetes on diabetic retinopathy. Ophthalmology 1982;89:735-47.
60. Lauritzen T, Frost-Larsen K, Larsen HW, Deckert T, Steno Study Group. Effect of 1 year of near-normal blood glucose levels on retinopathy in insulin-dependent diabetics. Lancet 1983;1:200-4.
61. Lauritzen T, Frost-Larsen K, Larsen H, Deckert T. Two-year experience with continuous subcutaneous insulin infusion in relation to retinopathy and neuropathy. Diabetes 1985;34:Suppl 3:74-9.
62. The Kroc Collaborative Study Group. Blood glucose control and the evolution of diabetic retinopathy and albuminuria: a preliminary multicenter trial. N Engl J Med 1984;311:365-72.
63. Idem. Diabetic retinopathy after two years of intensified insulin treatment: follow-up of the Kroc Collaborative Study. JAMA 1988;260:37-41.
64. The Diabetes Control and Complications Trial Research Group. Early worsening of diabetic retinopathy in the Diabetes Control and Complications Trial. Arch Ophthalmol 1998;116:874-86. [Erratum, Arch Ophthalmol 1998;116:1469.]
65. Aubert RE, Ballard DJ, Barrett-Connor E, et al. Diabetes in America. 2nd ed. Washington, D.C.: National Institute of Diabetes and Digestive and Kidney Diseases, 1995. (NIH publication no. 95-1468.)
66. Hypertension in Diabetes Study (HDS). I. Prevalence of hypertension in newly presenting type 2 diabetic patients and the association with risk factors for cardiovascular and diabetic complications. J Hypertens 1993;11: 309-17.
67. Knowler WC, Bennett PH, Ballintine EJ. Increased incidence of retinopathy in diabetics with elevated blood pressure: a six-year follow-up study in Pima Indians. N Engl J Med 1980;302:645-50.
68. Hamman RF, Mayer EJ, Moo-Young GA, Hildebrandt W, Marshall JA, Baxter J. Prevalence and risk factors of diabetic retinopathy in non-Hispanic whites and Hispanics with NIDDM: San Luis Valley Diabetes Study. Diabetes 1989;38:1231-7.
69. Yanko L, Goldbourt U, Michaelson IC, Shapiro A, Yaari S. Prevalence and 15-year incidence of retinopathy and associated characteristics in middle-aged and elderly diabetic men. Br J Ophthalmol 1983;67:759-65.
70. Kohner EM, Aldington SJ, Stratton IM, et al. United Kingdom Prospective Diabetes Study, 30: diabetic retinopathy at diagnosis of non-insulin dependent diabetes mellitus and associated risk factors. Arch Ophthalmol 1998;116:297-303.
71. Chaturvedi N, Sjolie AK, Stephenson JM, et al. Effect of lisinopril on progression of retinopathy in normotensive people with type 1 diabetes. Lancet 1998;351:28-31.
72. UK Prospective Diabetes Study Group. Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 38. BMJ 1998;317:703-13.
73. Idem. Efficacy of atenolol and captopril in reducing risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 39. BMJ 1998;317:713-20.
74. Frank RN. The aldose reductase controversy. Diabetes 1994;43:169-72.
75. Kinoshita JH. Mechanisms initiating cataract formation. Invest Ophthalmol 1974;13:713-24.
76. Gabbay KH. Hyperglycemia, potyol metabolism, and complications of diabetes mellitus. Annu Rev Med 1975;26:521-36.
77. Kador PF, Akagi Y, Takahashi Y, Ikebe H, Wyman M, Kinoshita JH. Prevention of retinal vessel changes associated with diabetic retinopathy in galactose-fed dogs by aldose reductase inhibitors. Arch Ophthalmol 1990; 108:1301-9.
78. Robison WG Jr, Laver NM, Jacot JL, et al. Diabetic-like retinopathy ameliorated with the aldose reductase inhibitor WAY-121,509. Invest Ophthalmol Vis Sci 1996;37:1149-56.
79. Sorbinil Retinopathy Trial Research Group. A randomized trial of sorbinil, an aldose reductase inhibitor, in diabetic retinopathy. Arch Ophthalmol 1990;108:1234-44.
80. Idem. The sorbinil retinopathy trial: neuropathy results. Neurology 1993;43:1141-9.
81. Aiello LP, Pierce EA, Foley ED, et al. Suppression of retinal neovascularization in vivo by inhibition of vascular endothelial growth factor (VEGF) using soluble VEGF-receptor chimeric proteins. Proc Natl Acad Sci U S A 1995;92:10457-61.
82. Smith LE, Kopchick JJ, Chen W, et al. Essential role of growth hormone in ischemia-induced retinal neovascularization. Science 1997;276: 1706-9.
83. Brownlee M, Cerami A, Vlassara H. Advanced glycosylation end products in tissue and the biochemical basis of diabetic complications. N Engl J Med 1988;318:1315-21.
84. Brownlee M, Vlassara H, Kooney A, Ulrich P, Cerami A. Amino-guanidine prevents diabetes-induced arterial wall protein cross-linking. Science 1986;232:1629-32.
85. Meyer-Schwickerath G. Light coagulation. St. Louis: C.V. Mosby, 1960.
86. Beetham WP, Aiello LM, Balodimos MC, Koncz L. Ruby-laser photocoagulation of early diabetic neovascular retinopathy: preliminary report of a long-term controlled study. Trans Am Ophthalmol Soc 1969;67:39-67.
87. Ederer F, Hiller R. Clinical trials, diabetic retinopathy and photocoagulation: a reanalysis of five studies. Surv Ophthalmol 1975;19:267-86.
88. Diabetic Retinopathy Study Research Group. Report 6: design, methods, and baseline results. Invest Ophthalmol Vis Sci 1981;21:149-209.
89. Idem. Preliminary report on effects of photocoagulation therapy. Am J Ophthalmol 1976;81:383-96.
90. Idem. Photocoagulation treatment of proliferative diabetic retinopathy: clinical application of Diabetic Retinopathy Study (DRS) findings, DRS report number 8. Ophthalmology 1981;88:583-600.
91. Idem. Four risk factors for severe visual loss in diabetic retinopathy: the third report of the Diabetic Retinopathy Study. Arch Ophthalmol 1979; 97:654-5.
92. Photocoagulation treatment of proliferative diabetic retinopathy: relationship of adverse treatment effects to retinopathy severity: Diabetic Retinopathy Study report no. 5. Dev Ophthalmol 1981;2:248-61.
93. Early Treatment Diabetic Retinopathy Study design and baseline patient characteristics: ETDRS report number 7. Ophthalmology 1991;98: 741-56.
94. Early Treatment Diabetic Retinopathy Study Research Group. Effects of aspirin treatment on diabetic retinopathy: ETDRS report number 8. Ophthalmology 1991;98:Suppl:757-65.
95. Sagel J, Colwell JA, Crook L, Laimins M. Increased platelet aggregation in early diabetes mellitus. Ann Intern Med 1975;82:733-8.
96. Dobbie JG, Kwaan HC, Colwell JA, Suwanwela N. The role of platelets in pathogenesis of diabetic retinopathy. Trans Am Acad Ophthalmol Otolaryngol 1973;77:OP-43-OP-47.
97. Regnault F. Role des plaquettes dans la pathogénie de la rétinopathie diabétique. Sem Hop Paris 1972;48:893-902.
98. Powell EDU, Field RA. Diabetic retinopathy and rheumatoid arthritis. Lancet 1964;2:17-8.
99. Carroll WW, Geeraets WJ. Diabetic retinopathy and salicylates. Ann Ophthalmol 1972;4:1019-45.
100. Chew EY, Klein ML, Murphy RP, Remaley NA, Ferris FL III. Effects of aspirin on vitreous/preretinal hemorrhage in patients with diabetes mellitus: Early Treatment Diabetic Retinopathy Study report no. 20. Arch Ophthalmol 1995;113:52-5.
101. The ETDRS Investigators. Aspirin effects on mortality and morbidity in patients with diabetes mellitus: Early Treatment Diabetic Retinopathy Study report 14. JAMA 1992;268:1292-300.
102. Early Treatment Diabetic Retinopathy Study Research Group. Early photocoagulation for diabetic retinopathy: ETDRS report number 9. Ophthalmology 1991;98:Suppl:766-85.
103. Ferris F. Early photocoagulation in patients with either type I or type II diabetes. Trans Am Ophthamol Soc 1996;94:505-37.
104. Early Treatment Diabetic Retinopathy Study Research Group. Photocoagulation for diabetic macular edema: Early Treatment Diabetic Retinopathy Study report number 1. Arch Ophthalmol 1985;103:1796-806.
105. Idem. Treatment techniques and clinical guidelines for photocoagulation of diabetic macular edema: Early Treatment Diabetic Retinopathy Study report number 2. Ophthalmology 1987;94:761-74.
106. Idem. Techniques for scatter and local photocoagulation treatment of diabetic retinopathy: Early Treatment Diabetic Retinopathy Study report no. 3. Int Ophthalmol Clin 1987;27:254-64.
107. Idem. Photocoagulation for diabetic macular edema: Early Treatment Diabetic Retinopathy Study report no. 4. Int Ophthalmol Clin 1987;27: 265-72.
108. Machemer R, Parel J-M, Buettner H. A new concept for vitreous surgery. 1. Instrumentation. Am J Ophthalmol 1972;73:1-7.
109. Machemer R. A new concept for vitreous surgery. 2. Surgical technique and complications. Am J Ophthalmol 1972;74:1022-33.
110. Machemer R, Norton EWD. A new concept for vitreous surgery. 3. Indications and results. Am J Ophthalmol 1972;74:1034-56.
111. The Diabetic Retinopathy Vitrectomy Study Research Group. Two-year course of visual acuity in severe proliferative diabetic retinopathy with conventional management: Diabetic Retinopathy Vitrectomy Study (DRVS) report #1. Ophthalmology 1985;92:492-502.
112. Idem. Early Vitrectomy for severe vitreous hemorrhage in diabetic retinopathy: two-year results of a randomized trial: Diabetic Retinopathy Vitrectomy Study report 2. Arch Ophthalmol 1985;103:1644-52.
113. Idem. Early vitrectomy for severe proliferative diabetic retinopathy in eyes with useful vision: results of a randomized trial - Diabetic Retinopathy Vitrectomy Study report 3. Ophthalmology 1988;95:1307-20.
114. Idem. Early vitrectomy for severe proliferative diabetic retinopathy in eyes with useful vision: clinical application of results of a randomized trial - Diabetic Retinopathy Vitrectomy Study report 4. Ophthalmology 1988; 95:1321-34.
115. Idem. Early vitrectomy for severe vitreous hemorrhage in diabetic retinopathy: four-year results of a randomized trial: Diabetic Retinopathy Vitrectomy Study report 5. Arch Ophthalmol 1990;108:958-64. [Erratum, Arch Ophthalmol 1990;108:1452.]
116. Smiddy W, Feuer W, Irvine WD, Flynn HW Jr, Blankenship GW. Vitrectomy for complications of proliferative diabetic retinopathy: functional outcomes. Ophthalmology 1995;102:1688-95.
117. Smiddy WE. Vitrectomy for complications of diabetic retinopathy. Int Ophthalmol Clin 1998;38:155-67.
118. Moss SE, Klein R, Klein BE. Factors associated with having eye examinations in persons with diabetes. Arch Fam Med 1995;4:529-34.
119. Sprafka J, Fritsche T, Baker R, Kurth D, Whipple D. Prevalence of undiagnosed eye disease in high-risk diabetic individuals. Arch Intern Med 1990;150:857-61.
120. Will JC, German RR, Schuman E, Michael S, Kurth DM, Deeb L. Patient adherence to guidelines for diabetes eye care: results from the diabetic eye disease follow-up study. Am J Public Health 1994;84:1669-71.
121. Javitt JC, Canner JK, Sommer A. Cost effectiveness of current approaches to the control of retinopathy in type 1 diabetics. Ophthalmology 1989;96:255-64.
122. Kupfer C. The challenge of transferring research results into patient care. Ophthalmology 1989;96:737-8.
123. Klein R. Eye-care delivery for people with diabetes. Diabetes Care 1994;17:614-5.
124. Idem. Barriers to prevention of vision loss caused by diabetic retinopathy. Arch Ophthalmol 1997;115:1073-5.
125. The Diabetes Control and Complications Trial Research Group. Lifetime benefits and costs of intensive therapy as practiced in the Diabetes Control and Complications Trial. JAMA 1996;276:1409-15. [Erratum, JAMA 1997;278:25.]
126. Ackerman SJ. Benefits of preventive programs in eye care are visible on the bottom line: a new nationwide effort to improve eye care for people with diabetes gets backing from a study on cost effectiveness of screening for retinopathy. Diabetes Care 1992;15:580-1.
127. Javitt JC, Aiello LP, Chiang Y, Ferris FL III, Canner JK, Greenfield S. Preventive eye care in people with diabetes is cost-saving to the federal government: implications for health-care reform. Diabetes Care 1994;17:909-17.
128. Javitt JC, Aiello LP. Cost-effectiveness of detecting and treating diabetic retinopathy. Ann Intern Med 1995;124:164-9.