Retinopathy in old persons with and without diabetes mellitus: The Age, Gene/Environment Susceptibility-Reykjavik Study (AGES-R)

E. Gunnlaugsdottir, S. Halldorsdottir, R. Klein, G. Eiriksdottir, B. E. Klein, R. Benediktsson, T. B. Harris, L. J. Launer, T. Aspelund, V. Gudnason, M. F. Cotch*, F. Jonasson

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

23 Citations (Scopus)

Abstract

Aims/hypothesis: We aimed to describe the prevalence of retinopathy in an aged cohort of Icelanders with and without diabetes mellitus. Methods: The study population consisted of 4,994 persons aged ≥67 years, who participated in the Age, Gene/Environment Susceptibility-Reykjavik Study (AGES-R). Type 2 diabetes mellitus was defined as HbA 1c ≥6.5% (>48 mmol/mol). Retinopathy was assessed by grading fundus photographs using the modified Airlie House adaptation of the Early Treatment Diabetic Retinopathy Study protocol. Associations between retinopathy and risk factors were estimated using odds ratios obtained from multivariate analyses. Results: The overall prevalence of retinopathy in AGES-R was 12.4%. Diabetes mellitus was present in 516 persons (10.3%), for 512 of whom gradable fundus photos were available, including 138 persons (27.0%, 95% CI 23.2, 31.0) with any retinopathy. Five persons (1.0%, 95% CI 0.3, 2.3) had proliferative retinopathy. Clinically significant macular oedema was present in five persons (1.0%, 95% CI 0.3, 2.3). Independent risk factors for retinopathy in diabetic patients in a multivariate model included HbA 1c, insulin use and use of oral hypoglycaemic agents, the last two being indicators of longer disease duration. In 4478 participants without diabetes mellitus, gradable fundus photos were available for 4,453 participants, with retinopathy present in 476 (10.7%, 95% CI 9.8, 11.6) and clinically significant macular oedema in three persons. Independent risk factors included increasing age and microalbuminuria. Conclusions/interpretation: Over three-quarters (78%) of retinopathy cases were found in persons without diabetes and a strong association between microalbuminuria and non-diabetic retinopathy was found. These results may have implications for patient management of the aged.

Original languageEnglish
Pages (from-to)671-680
Number of pages10
JournalDiabetologia
Volume55
Issue number3
DOIs
Publication statusPublished - Mar 2012

Bibliographical note

Funding Information:
Acknowledgements We thank the AGES-R participants for making this study possible. The Age, Gene/Environment Susceptibility-Reykjavik Study is funded by NIH contract N01-AG-12100, the NIH/NIA Intramural Research Program, the National Eye Institute (NEI) of the NIH (ZIAEY000401), Hjartavernd (the Icelandic Heart Association), the Althingi (the Icelandic Parliament) and the University of Iceland Research Fund.

Other keywords

  • Diabetes mellitus
  • Microalbuminuria
  • Non-diabetic
  • Old age
  • Population sample
  • Random
  • Retinopathy

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