INCIDENCE OF BLINDNESS IN RELATION TO DIABETES - A POPULATION-BASED STUDY

OBJECTIVE - A reduction of diabetes-related blindness was declared a p rimary objective for Europe (St. Vincent Declaration). We collected da ta about incidence rates of blindness in the diabetic population compa red with the nondiabetic population. Up to now such data are scarce-ev en worldwide. RESEARCH DESIGN AND METHODS - A complete list of newly r egistered blindness allowance recipients was drawn up in the district of Wurttemberg-Hohenzollern, Germany, between 1990 and 1993. From thes e data, we estimated age-specific and standardized incidence rates of blindness in the entire, the diabetic, and the nondiabetic population, as well as relative and attributable risks due to diabetes. RESULTS - There were 2,714 people meeting the inclusion criteria; 1,823 (67.2%) were female and 781 (28.8%) had diabetes. In 318 subjects, diabetes w as likely to be the only cause of blindness; in 192 subjects, it was o ne of several contributory causes. Age of women was 73.9 +/- 19.4 year s (mean +/- SD) and of men 63.3 +/- 25.5 years. Results standardized t o the (West) German population are as follows: incidence rates (per 10 0,000 person-years): total population: 13.5; diabetic population: 60.6 ; nondiabetic population: 11.6; relative risk: 5.2; attributable risk among exposed: 0.81; and population attributable risk: 0.14. The relat ive risks decreased considerably with increasing age. When the study i s repeated to monitor the St. Vincent targets, a reduction in the inci dence rate of blindness in the diabetic population by 17% will be dete cted with 95% power. CONCLUSIONS - Great relative and attributable ris ks, especially in younger age-groups, indicate the need for increased attention to preventive measures for microvascular complications.