Prevalence and Risk Factors of Retinopathy in an Asian Population Without Diabetes The Singapore Malay Eye Study

Objective: To describe the prevalence and risk factors of retinopathy in an Asian population without diabetes. Methods: We conducted a population-based, cross-sectional study of 3280 Malays aged 40 to 80 years residing in Singapore. Participants had retinal photographs taken, which were graded for retinopathy signs using the modified Airlie House Classification System. Risk factors were assessed from standardized interviews, clinical examinations, and laboratory investigations. Results: Of participants without diabetes (n=2500), 149 (6.0%; 95% confidence interval [CI], 5.0-6.9) had signs of retinopathy that represented minimal (5.8%) or mild (0.2%) retinopathy. After adjusting for multiple covariables, higher serum glucose levels (odds ratio [OR], 1.13; 95% CI, 1.00-1.28; per millimole per liter increase), higher systolic blood pressure (OR, 1.15; 95% CI, 1.06-1.25; per 10-mm Hg increase), higher body mass index (OR, 1.04; 95% CI, 1.00-1.07 per point increase), and a history of heart attack (OR, 2.68; 95% CI, 1.48-4.83) were significantly associated with the presence of retinopathy lesions in persons without diabetes. Conclusions: Similar to studies in white individuals, signs of retinopathy are common in Asian persons without diabetes. Early signs of retinopathy in persons without diabetes are related to metabolic and vascular risk factors and may indicate intermediate pathologic changes along the pathway to cardiovascular disease.