July 2019
Volume 60, Issue 9
Free
ARVO Annual Meeting Abstract  |   July 2019
Diabetic Retinopathy in the Thessaloniki Eye Study (TES): Prevalence and Risk Factors
Author Affiliations & Notes
  • Christina Keskini
    Laboratory of Research and Clinical Applications in Ophthalmology (LARCAO), Department of Ophthalmology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
  • Anne L Coleman
    Jules Stein Eye Institute,University of California Los Angeles (UCLA), Los Angeles, California, United States
  • M. Roy Wilson
    School of Medicine, Wayne State University, Detroit, Michigan, United States
  • Alon Harris
    Department of Ophthalmology, Eugene and Marilyn Glick Eye Institute, Indiana University School of Medicine, Indianapolis, Indiana, United States
  • Fei Yu
    Department of Biostatistics, UCLA Fielding School of Public Health, Los Angeles, California, United States
  • Panayiota Founti
    Laboratory of Research and Clinical Applications in Ophthalmology (LARCAO), Department of Ophthalmology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
    Glaucoma Unit, Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
  • Eleftherios Anastasopoulos
    Laboratory of Research and Clinical Applications in Ophthalmology (LARCAO), Department of Ophthalmology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
  • Anna-Bettina Haidich
    Department of Hygiene, Social-Preventive Medicine & Medical Statistics, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
  • Theofanis Pappas
    Laboratory of Research and Clinical Applications in Ophthalmology (LARCAO), Department of Ophthalmology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
  • Nikolaos Dervenis
    Laboratory of Research and Clinical Applications in Ophthalmology (LARCAO), Department of Ophthalmology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
  • Angelakis Malamas
    Laboratory of Research and Clinical Applications in Ophthalmology (LARCAO), Department of Ophthalmology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
  • Pelagia Kalouda
    Laboratory of Research and Clinical Applications in Ophthalmology (LARCAO), Department of Ophthalmology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
  • Vasileios Kilintzis
    Laboratory of Research and Clinical Applications in Ophthalmology (LARCAO), Department of Ophthalmology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
  • Angeliki Salonikiou
    Laboratory of Research and Clinical Applications in Ophthalmology (LARCAO), Department of Ophthalmology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
  • Archimidis Koskosas
    Laboratory of Research and Clinical Applications in Ophthalmology (LARCAO), Department of Ophthalmology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
  • Fotis Topouzis
    Laboratory of Research and Clinical Applications in Ophthalmology (LARCAO), Department of Ophthalmology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
  • Footnotes
    Commercial Relationships   Christina Keskini, None; Anne Coleman, Research to Prevent Blindness (F); M. Wilson, None; Alon Harris, AdOM (C), AdOM (I), CIPLA (C), Oxymap (I), Shire (C); Fei Yu, None; Panayiota Founti, None; Eleftherios Anastasopoulos, None; Anna-Bettina Haidich, None; Theofanis Pappas, None; Nikolaos Dervenis, None; Angelakis Malamas, None; Pelagia Kalouda, None; Vasileios Kilintzis, None; Angeliki Salonikiou, None; Archimidis Koskosas, None; Fotis Topouzis, Alcon (F), Alcon (R), Allergan (F), Bayer (C), Novartis (F), Novartis (R), Omikron (R), Pfizer (F), Pfizer (R), Pfizer (C), Santen (R), Thea (F), Thea (R)
  • Footnotes
    Support  Support IGA, London, UK, UCLA CEE, LA, CA, HFF, Creighton Univ, Omaha,NE, Texas Tech Univ, TX ,unrestricted grants: Pfizer, Inc. New York, NY, Pharmacia Hellas, Greece Merck&Co, Inc,NJ, Novartis AG, Basel, Switzerland
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 1088. doi:
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    • Get Citation

      Christina Keskini, Anne L Coleman, M. Roy Wilson, Alon Harris, Fei Yu, Panayiota Founti, Eleftherios Anastasopoulos, Anna-Bettina Haidich, Theofanis Pappas, Nikolaos Dervenis, Angelakis Malamas, Pelagia Kalouda, Vasileios Kilintzis, Angeliki Salonikiou, Archimidis Koskosas, Fotis Topouzis; Diabetic Retinopathy in the Thessaloniki Eye Study (TES): Prevalence and Risk Factors. Invest. Ophthalmol. Vis. Sci. 2019;60(9):1088.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To report diabetic retinopathy (DR) prevalence and risk factors in TES.

Methods : TES is a cross-sectional population-based study of eye diseases in Greece. 2554 randomly selected Caucasians aged ≥60 years were interviewed for demographics/lifestyle/medical history and underwent detailed ocular examination. Masked fundus photo DR grading was performed using a modified Airlie House classification. The highest score between two eyes defined the subject DR level: no DR, mild, moderate, severe non-proliferative DR (NPDR) and proliferative DR (PDR). Early Treatment Diabetic Retinopathy Study and Eye Diseases Prevalence Research Group definitions were used for clinically-significant macular edema (CSME) and sight-threatening retinopathy (STR), respectively. Self-reported diabetes mellitus (DM) defined diabetic subjects. Diabetics with DR were compared to those without DR for demographic/lifestyle/ocular/systemic factors. Multivariable logistic regression analysis was performed including factors with p<0.2 in univariate model. Odds ratios (OR) and 95% confidence intervals (CI) are reported.

Results : Fundus photos were gradable for 2175 subjects. The prevalence of DR was 6.9%(151/2175). 349 subjects had self-reported DM. The proportion of DR among diabetics was 31.2%(109/349); the proportion of mild, moderate, severe NPDR and PDR was 13.8%(48/349), 7.2%(25/349), 7.4%(26/349) and 2.9%(10/349), respectively. CSME was present in 6.6%(23/349) and STR in 12.0%(42/349) of diabetics. In multivariable analysis, male gender (OR:2.15;95%CI:1.07-4.31), DM treatment (Tx) duration (OR:1.06;95%CI:1.01-1.10 per year), insulin Tx (OR:5.30;95%CI:2.53-11.13), afternoon sleep (OR:2.03;95%CI:1.01-4.07), age (OR:0.88;95%CI:0.83-0.93 per year), migraine (OR:0.11;95%CI:0.01-0.97) and regular alcohol intake (Vs no/occasional,OR:0.41;95%CI:0.21-0.78) were significantly associated with DR. 27.8% of DR subjects did not report DM. 76.6% of DR subjects were unaware of DR presence.

Conclusions : Almost one third of diabetics had DR. Male gender, insulin Tx and longer DM Tx were related to higher DR risk. The positive association of afternoon sleep and the inverse association of age with DR may imply poor health status and selective mortality. The protective role of moderate alcohol intake may reflect beneficial vascular effects. High undiagnosed DR and undiagnosed DM rates in DR subjects highlight the need of improved primary and eye healthcare.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

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