Giuffrè G, Lodato G, Dardanoni G.:
Prevalence and risk factors of diabetic retinopathy in adult and elderly
subjects: The Casteldaccia Eye Study.
Graefes Arch Clin Exp Ophthalmol. 2004;242:535-40.


PURPOSE: To investigate the prevalence and risk factors of diabetic retinopathy
in subjects aged 40 years or older living in Casteldaccia, Sicily.
METHODS: A population-based survey was performed on 1,588 subjects randomly
enrolled among people aged 40 years or older. A total of 1,068 persons could be
examined and in 1,019 the fundus of the eye was adequately observed (64.2% of the
enrolled population). Diabetic retinopathy was diagnosed by ophthalmoscopy and
fundus photographs; fluorescein angiography was performed in 91% of retinopathic 
subjects. In addition, a case-control study was carried out in order to
demonstrate the association of diabetic retinopathy with a number of variables.
RESULTS: Diabetic retinopathy was found in 4.4% of the whole population studied
and in 34.1% of the diabetics. Nonproliferative diabetic retinopathy was found in
29.6% and proliferative diabetic retinopathy in 4.5% of the diabetics. Diabetic
retinopathy was significantly associated with the following univariate variables:
duration of diabetes, duration and type of antidiabetic treatment, and duration
of alcohol intake. After multivariate logistic regression the only variable
independently associated with diabetic retinopathy was duration of antidiabetic
treatment.
CONCLUSION: Diabetic retinopathy affects more than one third of diabetics and
represents a leading cause of retinal disease. The antidiabetic treatment is the 
most important risk factor for diabetic retinopathy, even stronger than the
duration of diabetes.