Diabetic retinopathy in people aged 70 years or older. The Oulu Eye Study
Department of Ophthalmology, University of Oulu,
Oulu, Finland
Correspondence to: Heli Hirvelä, MD, Department of Ophthalmology, University of Oulu, 90220 Oulu, Finland.
Accepted for publication 8 October 1996
AIMS
To evaluate the presence and severity
of diabetic retinopathy and the value of retinopathy screening in
people aged 70 years or older.
METHODSIn a population based study on 500 of 560 eligible (89%) people aged 70 years or older, signs of diabetic
retinopathy were evaluated through dilated pupils by an
ophthalmologist using photographic and/or ophthalmoscopic methods.
RESULTS23% of the study population
(113/500) had diabetes mellitus. Signs of diabetic retinopathy were
found in 24 people (21% of the diabetic population). Retinopathy
changes were graded as mild to moderate non-proliferative retinopathy
(NPDR) in 40 eyes (18 people), severe NPDR (preproliferative) in five
eyes (four people), and proliferative in three eyes (two people).
Preproliferative or proliferative changes were present in four people
(3.5% of the diabetic population) and diabetic maculopathy was
diagnosed in nine (8% of the diabetic population). Laser treatment was
considered to be indicated in seven people for maculopathy, and in two
for proliferative changes. In four people the visual acuity was reduced to a low vision level as a result of diabetic retinopathy.
CONCLUSIONIn spite of the high prevalence
of diabetes mellitus in the elderly population, the prevalence of
vision threatening diabetic retinopathy, particularly proliferative
retinopathy, is low. Ophthalmoscopically, reliable information on
fundus changes could be obtained in 94%, but photographs were gradable
in only 76% of the diabetic population. Therefore, the value of
photographic screening for diabetic retinopathy in this age group is
poor in comparison with younger age groups.
* Present address: Department of Ophthalmology, University of Helsinki, Helsinki, Finland.
© 1997 by British Journal of Ophthalmology
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