Lower prevalence of proliferative diabetic retinopathy in elderly onset patients with diabetes

To assess diabetic retinopathy (DR) prevalence between elderly onset and younger onset diabetes with similar diabetes duration and evaluate the association between DR prevalence and serum insulin-like growth factor 1 (IGF-1) levels.

A total of 1787 patients with diabetes were enrolled between January 2010 and November 2015. Fundoscopy examination was performed. Patients were divided into three groups by age of diagnosis (<45, 45-64, and ⩾65years) for the analysis of the prevalence of DR. Among them, 150 patients underwent serum IGF-1 measurement. The serum IGF-1 level was compared between patients <65years and ⩾65years.

Among 1787 patients, 779 (43.6%) had DR, in which proliferative DR (PDR) 229 (12.8%) patients. For similar diabetes duration, DR prevalence was lower in elderly onset patients. Patients ⩾65years at diagnosis had significantly lowest PDR prevalence of the three groups for similar diabetes duration. IGF-1 levels were lower in patients ⩾65years than in patients <65years (104.89±49.91ng/mL vs. 141.73±62.04ng/mL, P<0.001).

Elderly onset patients with diabetes have lower prevalence of PDR than those younger onset patients for similar diabetes duration, which may relate with lower serum IGF-1 levels in older patients. Thus, less stringent glycemic control in older onset patients with diabetes may not increase the prevalence of PDR.