Understanding the Risk Factors for Diabetic Retinopathy in Adults and the Elderly

A new institution-based case-control analysis of adults and older patients with diabetes found that the presence of systemic complications conferred an adjusted ~3.6-fold increase in odds of diabetic retinopathy—an effect size that elevates the priority of retinal screening in older populations.

The study evaluated 356 adults and elderly individuals with diabetes, examining presence and development of diabetic retinopathy as the primary endpoint. Poor glycemic control was independently associated with higher odds of retinopathy; longer diabetes duration and difficulty accessing eye exams also demonstrated independent associations, refining patient-level risk stratification for targeted surveillance.

Adherence to regular physical activity was associated with lower odds of retinopathy. Other modifiable determinants—access to home glucometry, receipt of health information, and more frequent diabetes appointments—showed protective associations, highlighting tangible targets for behavior-focused interventions and patient education.

Risk-stratified screening that prioritizes patients with systemic complications, long diabetes duration, poor glycemic control, or limited mobility will likely increase detection yield and optimize resource use. Pairing retinal screening with routine diabetes visits, shortening follow-up intervals for high-risk older adults, and directing outreach to patients with access barriers can improve uptake and case-finding efficiency, enabling more targeted deployment of ophthalmic resources.