Diabetes, fasting blood glucose and age-related maculopathy: The Blue Mountains Eye Study

PURPOSE: As diabetes is associated with other causes of visual loss (cataract, glaucoma) and elevated plasma fibrinogen, a risk factor for age-related maculopathy (ARM), our aim was to assess whether an association existed between diabetes and ARM. METHODS: After exclusions, 3228 persons aged 49-97 years were studied. Diabetes was assessed from history or fasting glucose > or = 7.0mmol/L. Early and ate ARM were graded from stereoscopic photographs. RESULTS: Late ARM (neovascular AMD or geographical atrophy) was found in 61 subjects (1.9%) while early ARM (large soft drusen and/or retinal pigment changes) was found in 171 (5.2%) subjects. Diabetes was present in 276 subjects (8.6%). Late ARM was present in 3.3% of subjects with and in 1.8% without diabetes. However, after adjusting for ARM risk factors, this difference was not statistically significant (OR 2.0; CI 0.9-4.6). Geographic atrophy was significantly associated with diabetes (OR 4.0; CI 1.6-10.3), but no association was found with either exudative ARM (OR 1.2; CI 0.4-3.5) or early ARM (OR 1.0; CI 0.5-1.8). No ARM associations were found with impaired fasting glucose. CONCLUSIONS: This study has found no consistent relationship between diabetes and ARM, apart from a statistically significant association with geographical atrophy alone.