<![CDATA[Background: Diabetic retinopathy (DR) poses a critical threat to the productive workforce in developing nations. While disease duration and hyperglycemia are established risk factors, the distinct clinical aggression of young-onset Type 2 diabetes remains under-characterized in resource-limited settings. This study aimed to identify independent predictors of Proliferative Diabetic Retinopathy (PDR), specifically evaluating the differential risk profiles between working-age and elderly patients. Methods: A retrospective cross-sectional study was conducted on 118 patients with confirmed DR (NPDR=41; PDR=77) at a tertiary eye center in Indonesia. Multivariate logistic regression was performed to determine independent predictors, adjusting for potential confounders including hypertension and gender. Results: The cohort exhibited a high prevalence of advanced disease (65.3% PDR). Multivariate analysis revealed that age ≥60 years was significantly associated with a reduced risk of PDR (aOR 0.280; 95% CI 0.098–0.803; p=0.017), indicating an approximately 3.6-fold higher risk in the working-age demographic (40–59 years). Diabetes duration ≥10 years (aOR 3.805; p=0.006) and HbA1c ≥7.2% (aOR 3.856; p=0.006) were confirmed as robust independent predictors. Conclusion: Working-age patients exhibit a significantly more aggressive disease phenotype independent of diabetes duration and glycemic control. These findings suggest that current age thresholds may underestimate risk in younger populations, supporting the need for intensified retinal screening immediately upon diagnosis for early-onset patients to mitigate the socioeconomic impact of premature blindness.]]>
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