Clinical, Socioeconomic, and Demographic Factors Associated with Diabetic Retinopathy in a Hospital-Based Screening Program: A Cross-Sectional Study in Oslo, Norway.

Background: Diabetic retinopathy (DR) is a major cause of visual impairment. Its clinical determinants are well-established, whereas socioeconomic associations vary across settings. Objective: To estimate the observed proportion of DR and examine associations between clinical, demographic, and socioeconomic factors and DR among adults attending a hospital-based screening program in Oslo, Norway. Methods: This cross-sectional study analyzed 118 adults with diabetes. DR was graded from wide-field retinal images. A complete-case multivariable logistic regression model included age, diabetes duration, HbA1c, BMI, diabetes type, education level, and economic activity. Results: DR was present in 67 participants (56.8%). The adjusted model included 93 participants (53 with DR and 40 without DR). Longer diabetes duration was associated with higher odds of DR (adjusted odds ratio [aOR] 1.27 per year, 95% CI 1.14-1.41; p < 0.001), whereas age showed an inverse association (aOR 0.89 per year, 95% CI 0.82-0.97; p = 0.006). HbA1c, BMI, diabetes type, education, and economic activity were not statistically significant after adjustment. Conclusions: No statistically significant associations between the measured socioeconomic factors and DR were identified in this study sample. Clinically relevant associations and causal inference cannot be assumed because of possible selection bias and cross-sectional study design.