We wish to update our report on the action to control cardiovascular risk in diabetes accord eye study july 15, 2010, issue. Sep 01, 2010 the accord eye study was designed to evaluate the effects of these medical therapies on the progression of diabetic retinopathy figure 2. And in this trial there was a positive result with a 33% reduction in progression of retinopathy in patients who were. The designs of the accord study and the accord eye study are described elsewhere 1,6. Nihsupported accord eye study finds two therapies slow diabetic eye disease progression in highrisk adults with type 2 diabetes, researchers have found that two therapies may slow the progression of diabetic retinopathy, an eye disease that is the leading cause of vision loss in workingage americans. The action to control cardiovascular risk in diabetes eye study accordeye, a prospective study of a subset of patients in the randomized controlled clinical accord trial, is being conducted at enrollment and after 4 years of followup to assess the progression of dr with standardized comprehensive eye exams and fundus photography. The positive effect on retinopathy progression of adding fenofibrate to simvastatin for dyslipidemia was a surprise. The action to control cardiovascular risk in diabetes eye study accord eye, a prospective study of a subset of patients in the randomized controlled clinical accord trial, is being conducted at enrollment and after 4 years of followup to assess the progression of dr with standardized comprehensive eye. A comprehensive, standardised eye examination was conducted by a. The first combined advanced kidney and eye disease and was intended to approximate the primary microvascular outcome of the ukpds study.
In the accord study of patients with type 2 diabetes mean age, 62. Accord action to control cardiovascular risk in diabetes. At 4 years, there was a 33% reduction in retinopathy progression in the intensive arm 7. The accord eye study involved a subset of 2,856 participants. Our finding could expand the conclusion from the accord eye study 14,15 that the group receiving statins and fenofibrate had the lowest risk of diabetic retinopathy 6. Therapeutics intensifying glucose control and adding the. The positive effect on retinopathy progression of adding fenofibrate to. Pmc free article cushman wc, evans gw, byington rp, goff dc, jr, grimm rh, jr, cutler ja, et al. The accord study data and biospecimens are now available in the nhlbi biological specimen and data repository information coordinating center biolincc overview of accord and accordion. Retinal physician lessons learned from the accord eye study. Accordeye substudy a subgroup of 2856 participants were also included in the accordeye substudy evaluating the effects of the three interventions glycemia, blood pressure and lipids on the primary outcome of the composite of progression of dia. Accord is one of the largest studies ever conducted in adults with type 2 diabetes who were at especially high risk of cardiovascular events, such as heart attacks, stroke, or death from cardiovascular disease.
The niddk funded the landmark diabetes control and complications trial dcct to see if people with type 1 diabetes who kept their blood glucose levels as close to normal as safely possible with intensive diabetes treatment 3 or more shots of insulin per day or an insulin pump with selfmonitoring of blood glucose at least 4 times per day could slow the development of eye, kidney, and nerve. The accord eye study was designed to evaluate the effects of the 3 interventions on the development and progression of diabetic retinopathy in a subset of accord study participants. Study of diagnostic accord between general practitioners. Eye substudy patients were evaluated at two standardized and comprehensive eye examinations for the effects of the accord interventions at 4 years on the progression of diabetic retinopathy by 3 or more steps on the early treatment diabetic retinopathy study severity scale as assessed from sevenfield stereoscopic fundus photographs, with 17. Listing a study does not mean it has been evaluated by the u.
Accord eye study in addition, there was another substudy of the accord trial called the accord eye study, which took a small subgroup of patients and looked at factors that contributed toward progression of diabetic retinopathy. Accord eye study finds two therapies slow progression of. Diabetic retinopathy dr is a major microvascular complication of diabetes mellitus. Diabetic dyslipidemia, which has also been called atherogenic dyslipidemia a term that describes the lipid abnormalities in people with. The eyes have it why and how you see longwood seminars, march 6, 2014 how the eye works the eye is often compared to a camera, but in truth, the organ of sight is far more complex and efficient.
Accord eye substudy a subgroup of 2856 participants were also included in the accord eye substudy evaluating the effects of the three interventions glycemia, blood pressure and lipids on the primary outcome of the composite of progression of dia. Clinical implications of the accord trial the journal of. Our finding could expand the conclusion from the accordeye study 14,15 that the group receiving statins and fenofibrate had the lowest risk of diabetic retinopathy 6. The primary microvascular outcome of the trial was tested with 2856 study participants in the accord eye study by measuring whether the progression of diabetic retinopathy could be prevented. The cardiovascular benefits of fibrates have been shown to be heterogeneous and to depend on the presence of atherogenic dyslipidemia. Rationale, design, and methods of the action to control. At baseline and year 4, the subset of participants received comprehensive eye exams consisting of visual acuity evaluation and color fundus photographs of the seven stereoscopic fields. Discover accord clinics even though the accord trial and subsequent accordion followup study have been successfully completed, this website acts as a public referencial hub for the research, findings, and any other related news. There was, however, no effect of fenofibrate on moderate vision loss.
Accord study group and accord eye study group effects of medical therapies on retinopathy progression in type 2 diabetes. The action to control cardiovascular risk in diabetes eye study accordeye, a prospective study of a subset of patients in the randomized controlled clinical accord trial, is being conducted at enrollment and after 4 years of followup to assess the progression of dr with standardized comprehensive eye. Atherosclerotic cardiovascular disease is increased severalfold in most patients with type 2 diabetes, particularly patients who are older and have other risk factors 1,2. Researchers analyzed the effects of the treatment strategies on blood vessels in the eye by identifying diabetic retinopathy progression over four years. The study of more than 10,000 participants is sponsored by the national institutes of health. Mar 25, 2011 a surprising result of the accord eye study was the failure to demonstrate a significant effect of intensive blood pressure control on the progression of retinopathy.
The action to control cardiovascular risk in diabetes accord study is examining the effect of various treatments on cardiovascular disease in people with diabetes. Jobson optical groups story jobson optical group, located in new york city, new york, integrates print, web, research, data licensing and custom publishing solutions to meet the complete needs of every facet of the eye care industry. The accord action to control cardiovascular risk in diabetes. The eye substudy of the action to control cardiovascular risk in diabetes accord 27 trial was designed to test the effect of the accord interventions strategies to control blood glucose levels, blood lipid levels, and blood pressure on the development and progression of diabetic retinopathy. Fenofibrate and statin therapy, compared with placebo and. Ppara polymorphism influences the cardiovascular benefit of. Briefly, the accord study was a multicenter study with a total of 10,251 participants randomly assigned in equal numbers to two glycemia management treatment arms. The designs of the accord study and the accord eye study are described elsewhere. Effects of medical therapies on retinopathy progression in. Action to control cardiovascular risk in diabetes accord accord the safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Accord eye trial, the effect of fenofibrate was independent of glycemia. The accord action to control cardiovascular risk in. Contains haar cascade definitions, camshift and dynamic template matching trackers. Realtime face detection and tracking, as well as general methods for detecting, tracking and transforming objects in image streams.
Research design and methods the accord study 20032009 randomized participants with type 2. Moreover, in the accord lipid and blood pressure substudies, neither fenofibrate nor intensive antihypertensive therapy resulted in fewer. Accord eye study group, chew ey, ambrosius wt, davis md, et al. Accord eye study type 2 diabetes 2003 2009 three medical therapies n10,251. The 4year study may have been too short to affect the latter. Objectivesto identify diagnostic accord and disagreement between general practitioners and an ophthalmologist and thereby determine how undergraduate and nonspecialist postgraduate ophthalmic training could be improved. The action to control cardiovascular risk in diabetes eye study accord eye, a prospective study of a subset of patients in the randomized controlled clinical accord trial, is being conducted at enrollment and after 4 years of followup to assess the progression of dr with standardized comprehensive eye exams and fundus photography. Lack of association between thiazolidinediones and macular. Openurl1crossref2pubmed3 diabetic retinopathy is the commonest microvascular complication of diabetes and is still a leading cause of blindness in both the. We investigated whether genetic variability in the ppara gene, coding for the pharmacological target of fibrates ppar. Further evidence is now available on the value of the management of dyslipidaemia on diabetic retinopathy from the accord eye study. Jul, 2010 the accord study group and accord eye study group. Action to control cardiovascular risk in diabetes accord. Designcomparison of diagnosis of presenting conditions by general practitioners and one ophthalmologist in patients consulting general.
In the accord eye study, of those randomized to fenofibrate, 6. These associated risk factors include hypertension, obesity, and dyslipidemia. The accord eye study clearly indicates that intensive glycemic control and fibrate treatment added to statin therapy separately reduce the progression of diabetic retinopathy, emily chew, md, chair of the eye study and chief of the clinical trials branch of the division of epidemiology and clinical applications at the national eye. Effects of medical therapies on retinopathy progression in type 2 diabetes. Research design and methods the accord study 20032009 randomized participants with. Prespecified microvascular outcomes in accord were measures of kidney function, diabetic eye complications, and peripheral neuropathy. It is possible that the median systolic pressure of 3 mm hg in the nonintensive treatment group was an effective level for preventing progression or that the duration of follow. The accord eye study was designed to evaluate the effects of these medical therapies on the progression of diabetic retinopathy figure 2. Landmark accord trial finds intensive blood pressure and.
Diabetic retinopathy is a disease in which blood vessels in the eyes lightsensitive retinal tissue are damaged by diabetes. Effects of intensive blood pressure control in type 2 diabetes mellitus. Jobson optical group customer case study accord lms. The accord eye study nct00542178, described by the accord study group and accord eye study group in this issue of the journal, 1 is a subgroup study of the.
Nihsupported accord eye study finds two therapies slow. Objectives this study investigated whether the beneficial effects of intensive glycemic control and fenofibrate treatment of dyslipidemia in reducing retinopathy progression demonstrated in the action to control cardiovascular risk in diabetes accord eye study persisted beyond the clinical trial. Diabetic retinopathy dr is an eye disease that can occur in people with diabetes and can cause poor vision or blindness. Aug, 20 eye substudy patients were evaluated at two standardized and comprehensive eye examinations for the effects of the accord interventions at 4 years on the progression of diabetic retinopathy by 3 or more steps on the early treatment diabetic retinopathy study severity scale as assessed from sevenfield stereoscopic fundus photographs, with 17. Mar 25, 2011 further evidence is now available on the value of the management of dyslipidaemia on diabetic retinopathy from the accord eye study. The effects of medical management on the progression of.
Evaluating how the treatments in the action to control. Funded by the national heart, lung, and blood institute and others. Although the prevalence of all stages of diabetic retinopathy has been declining since 1980 in populations with improved diabetes control, the crude prevalence of visual impairment and blindness caused by diabetic retinopathy worldwide increased between 1990 and 2015, largely because of the increasing prevalence of type 2 diabetes, particularly in lowincome and middleincome countries. Overall, the accord eye trial has added substantially to our knowledge and confidence about the importance. Whether an enhanced effect of fenofibrate in the accord eye study is the result of an interaction with simvastatin will be an interesting topic for further research.
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