Do retinopathy signs in non-diabetic individuals predict the subsequent risk of diabetes?.

Wong TY, Mohamed Q, Klein R, Couper DJ. Br J Ophthalmol. 2006 Mar;90(3):301-3.

Retinal Vascular Imaging Centre, Centre for Eye Research Australia, Univeristy of Melbourne, 32 Gisborne Street, VIC 3002, Australia. twong@unimelb.edu.au

BACKGROUND/AIMS: Isolated retinopathy signs are common in non-diabetic individuals and have been shown to be associated with impaired glucose metabolism. In a cohort of people without diabetes, the association of these retinopathy signs and subsequent development of diabetes were examined.
METHODS: A population based cohort study of 7992 people aged 49-73 years without diabetes was conducted. Retinal photographs of these participants were evaluated for the presence of retinopathy signs according to a standardised protocol. Incident cases of diabetes were identified prospectively.
RESULTS: After a follow up of 3 years, 291 (3.6%) people developed incident diabetes. In the total cohort, retinopathy was not significantly associated with incident diabetes (4.7% v 3.6%, multivariable adjusted odds ratio (OR) 1.1, 95% confidence intervals (CI), 0.7 to 1.9). However, among participants with a positive family history of diabetes, retinopathy was associated with incident diabetes (10.4% v 4.8%, multivariable adjusted OR 2.3, 95% CI, 1.0 to 5.3). Among participants without a family history of diabetes, retinopathy was not associated with incident diabetes.
CONCLUSIONS: In individuals with a family history of diabetes, retinopathy signs predict subsequent risk of clinical diabetes.