Prevalence of diabetic retinopathy and eye care in a rural area of Spain.

OBJECTIVE: To study the prevalence of diabetic retinopathy (DR) in a sample of 3544 patients living in a rural area of the province of Valladolid, Spain; as well as to estimate the current eye care to the diabetic population.
METHODS: Participants received a comprehensive ocular examination in their local area where they resided and a grading of DR was made using standard protocols. Physicians then provided us with the systemic and demographic data.
RESULTS: The population studied included 175 younger-onset and 3344 older-onset patients, all of whom were under physicians' care, distributed in an 18-county-area far from the urban center. Mean duration of the disease was 7.89 +/- 7.7 years (range 0 to 59 years). 73% of participants had not received ophthalmologic care the preceding year and 63.6% had not received a dilated eye examination either. The prevalence of DR was 20.9%; macular edema was found in 5.7% of the patients. Differences in participation were found among counties and these also correlated with differences in prevalence of DR. Prevalence of DR in the younger-onset group was 25.6% and 14.81% in insulin- and non-insulin-dependent patients, respectively. In the older-onset group, it was present in 48.6% and 14.7% of insulin- and non-insulin-dependent patients. Patients with retinopathy were older, with a longer duration of disease, were insulin dependent and had had less eye care.
CONCLUSIONS: Deficient screening of ophthalmic disease in diabetic patients should be improved, especially in isolated areas, in order to reduce DR in this group. Insulin-dependent older-onset patients with a longer duration of diabetes had a higher frequency of these complications.