Clinical correlates of advanced retinopathy in type II diabetic patients: Implications for screening

The clinical correlates of advanced retinopathy were determined in a sample of 427 type II diabetic outpatients, aged 35 to 74 years, recruited in eight centers from all parts of France. The presence of retinopathy was assessed by fluorescein angiography with centralized interpretation. Advanced retinopathy (proliferative and/or macular edema) was independently linked with nephropathy, peripheral neuropathy, and insulin therapy. Prevalence of advanced retinopathy was 1.6% in the absence of signs of nephropathy and/or peripheral neuropathy, 10.4% in patients with mild signs, and 17.5% in patients with moderate to severe signs. Overall, 87% of the patients with advanced retinopathy had signs of nephropathy and/or peripheral neuropathy. In conclusion, patients showing signs of nephropathy and/or peripheral neuropathy should be sent in priority to an ophthalmologist. Prospective data are necessary to determine if screening is necessary in patients with no signs of nephropathy or peripheral neuropathy.