Abstract
Purpose:
The association between alcohol consumption and diabetic retinopathy (DR) has been poorly explored, with equivocal findings. We explored the association between the type and level of alcohol consumption, and DR and vision impairment (VI).
Methods:
In this cross-sectional study at a tertiary eye hospital in Melbourne, Australia 368 patients with type 2 diabetes had a comprehensive ocular examination and answered questions on consumption of low strength beer, full-strength beer, white wine/champagne, red wine, sherry/port, and spirits over the last 12 months. Moderate and high consumption of each alcoholic beverage and overall alcoholic consumption for each individual was defined as 1-14 and >14 standard drinks/week, respectively. High consumption of sherry/port was not assessed due to lack of data. Dilated fundus photographs (disc- and macula-centred) were graded for severity of DR (non-vision threatening DR [non-VTDR-mild/mod non-proliferative DR (NPDR)] and VTDR (severe NPDR, PDR [proliferative DR] and/or clinically significant macular edema). VI was defined as presenting visual acuity (better eye) <6/12. Multivariable logistic regression was used to determine the associations between alcohol consumption and risk of DR and VI, adjusted for confounding variables, including smoking, HbA1c and duration of diabetes.
Results:
The mean age±SD [standard deviation] of patients with DR (males=154) was 68.4±10.8. In adjusted models, compared with abstainers, those who consumed moderate amounts of white wine/champagne or sherry/port had reduced odds of DR (OR=0.46, 95%CI [confidence interval] 0.23-0.92, p=0.029 and OR=0.17, 95%CI 0.05-0.60), p<0.006, respectively). Moderate consumption of white wine/champagne was protective for VTDR (OR=0.26, 95%CI 0.10-0.69, p=0.007). High consumption of white wine/champagne was not associated with DR. Moderate consumption of sherry/port was protective for both non-VTDR and VTDR (OR=0.24, 95%CI 0.06-0.91, p=0.035 and OR=0.08, 95%CI 0.01-24.04, p=0.035, respectively). Other alcoholic beverages and overall alcohol consumption were not associated with DR. VI was not associated with any type of alcohol consumption.
Conclusions:
We found that moderate consumption of white wine/champagne or sherry/port was protective of DR. This is consistent with the positive effect of moderate wine consumption on other vascular complications.