The Wisconsin Epidemiologic Study of Diabetic Retinopathy-Reply

In reply Drs Batchelder and Barricks suggest that our on the long-term incidence and progression of retinopathy contradict rather than support the guidelines 1 of yearly dilated retinal examinations 5 years after diagnosis of insulindependent diabetes mellitus (IDDM) in people younger than 30 years of age and 1 year after diagnosis of non—insulindependent diabetes mellitus (NIDDM) in people 30 years of age or older. 2 They suggest that the guidelines do not take into account the epidemiologic observations that people with any type of diabetes and no retinopathy or minimal retinopathy consisting of only microaneurysms are unlikely to progress to vision-threatening retinopathy over a 4-year period. 3-5 They suggest that the interval should be tailored to a patient's risk and that our data do not suggest any difference in effectiveness for screening intervals of 1, 2, or even 4 years for this group of lowrisk patients. In 1991,