Prevalence of and risk factors for diabetic retinopathy and diabetic macular edema in patients with early and late onset diabetes mellitus.

PURPOSE: To compare the prevalence of diabetic retinopathy (DR) and diabetic macular edema (DME), as well as their risk factors in patients with early onset diabetes (EOD, ≤40 years) and late onset diabetes (LOD, >40 years). METHODS: Patients were recruited from a community-based study, Fushun Diabetic Retinopathy Cohort Study (FS-DIRECT), conducted between July 2012 and May 2013 in China. The presence and severity of the DR and DME were determined by a modified Early Treatment Diabetic Retinopathy Study (ETDRS) retinopathy scale of six-field fundus photographs. RESULTS: A total of 1932 patients (796 male, 41.2%) with gradable fundus photography were included. The prevalence of any DR and DME was 67.0% (95% confidence interval [CI]: 60.3-73.7%) and 39.3% (95% CI: 32.1-46.5%) in the EOD patients respectively, which were both significantly higher than that in the LOD patients (DR: 41.9%, 39.6-44.2%, p<0.001; DME: 14.4%, 12.7-16.1%, p<0.001). Insulin use was associated with both presence of DR and DME in both EOD and LOD patients. Besides insulin use, high level of income (odds ratio [OR], 95% CI: 0.05, 0.01-0.51) was negatively associated with DR, and higher high density lipoprotein (OR, 95% CI: 4.14, 1.44-11.91) was associated with DME, among EOD patients. CONCLUSION: In this sample of patients with type 2 diabetes, both the prevalence of DR and DME were apparently higher in patients who developed diabetes ≤40 years of age than those who developed it later.