Retinopathy in older patients with diabetes mellitus

Abstract 

Purpose: We studied the effects of the age and/or disease duration in diabetics on the progression of diabetic retinopathy (DR). Methods: The population consisted of 3614 type 2 diabetes mellitus (DM) patients. The subjects were divided into three age groups (elderly, ≥65 years old; middle-aged, 64–40 years old, and younger <40 years old) for disease duration-adjusted comparison with and without DR and proliferative diabetic retinopathy (PDR). Then, in 503 patients with 8-year follow-up data available, the frequency of development/progression of DR and the rate of progression to PDR were compared among the three groups. Thirdly, in the elderly patients, DR prevalence and the frequency of the development/progression of DR were compared between two groups with different diabetes duration (≥6 years and ≤5 years). Results: The prevalence of DR increased significantly with age (P<0.001). The prevalence of PDR decreased significantly with age (P<0.001). The overall frequency of the development and/or progression of DR increased significantly with age (P=0.002); however, age was not related to the frequency of progression to PDR. In the patients with diabetes duration of 6–15 years, the frequency of the development/progression of DR and of progression to PDR after an 8-year follow up tended to decrease with age. Elderly patients with a diabetes duration of ≥6 years showed significantly higher rate of prevalence of DR and frequency of development/progression of DR in an 8-year period than those with diabetes of a shorter duration (P<0.001 and P<0.001, respectively). Conclusion: In elderly DM patients, the prevalence of DR was increased even in the short duration and development/progression rates of DR were increased, while the relative frequency of PDR was decreased. Older-onset DM patients appear to be at a lower risk for progression to PDR.

Keywords:  Diabetic retinopathy, Older patients, Proliferative diabetic retinopathy, Diabetes mellitus