DIABETIC-RETINOPATHY AS A CAUSE OF BLINDNESS IN THE PROVINCE OF TURIN, NORTH-WEST ITALY, IN 1967-1991

Diabetes is known to be a major contributor to blindness in industrial ized countries but few data are available on the situation in Italy. A s an introductory step to the implementation of permanent screening fo r diabetic retinopathy, a search was carried out on the causes of visu al loss in the provincial territory surrounding Turin, the main city o f North-West Italy. The case notes of all 4549 residents in the provin ce who were certified blind between 1967 and 1991 were examined with r egard to cause, age at onset, and year of onset of visual acuity less than or equal to 1/20. Diabetic retinopathy was the second commonest c ause of bilateral blindness (13.1 % of cases), preceded by cataract (2 6.7 %) and followed by myopia (11.1 %), optic atrophy (8.9 %), glaucom a (8.9 %), retinitis pigmentosa (7.2 %), and senile macular degenerati on (4.1 %). Diabetic retinopathy was the commonest eye disease among t hose who became blind between the ages of 50 and 70 and remained the l eading cause of visual loss when the age groups 20 to 70 were pooled t ogether. The incidence of diabetic retinopathy-related blindness did n ot show any trend to decrease over the 25 years investigated. It is co ncluded that, in spite of widespread availability of facilities for it s assessment and treatment, diabetic retinopathy remains a leading cau se of blindness in North-West Italy. This fully justifies the implemen tation of screening programmes and efficient referral chains for the e arly detection and prompt treatment of this complication of diabetes.