Diabetic eye screening in multi ethnic population of Malaysia: epidemiological risk factors for development of diabetic retinopathy

Naveen Kumar T, Nagi Reddy T, Radha Kishan N

Abstract


Background:The objective of this study is to evaluate epidemiological risk factors for development of diabetic retinopathy.

Methods:The cases of type-2 diabetes mellitus attending Melaka Manipal medical college, Malaysia were retrospectively reviewed. The epidemiological characteristics of diabetic retinopathy were estimated. The cases were graded according to degree of retinopathy in to: non-diabetic retinopathy group and diabetic retinopathy. Clinical and biochemical studies were used for studying the risk factors associated with development of retinopathy.

Results:The prevalence of diabetic retinopathy in the population was 21% in known diabetic subjects and was significantly higher in men than in women (21.3% vs. 14.6%) with increasing age and duration of diabetes. Ethnicity is a complex, independent risk factor for diabetic retinopathy. Sight threatening diabetic retinopathy, and clinically significant macular edema was higher in people of Malaysia (20%) when compared with Chinese (16%) and Indonesians (12%). In all, 55 percent of patients with known diabetes mellitus had never undergone an eye examination. Among patients who had undergone eye examinations, 32.8 percent had the last examination within the last one year, 49.8 percent within the last one to two years, and 17.4 percent more than two years ago.

Conclusion:Diabetic retinopathy is highly prevalent in the patients with type-2 diabetes mellitus in Malaysia. Besides blood glucose, many factors are associated with the present and development of diabetic retinopathy.

 


Keywords


Diabetic retinopathy, Risk factors, Type-2 diabetes mellitus

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References


Klein R, Klein BE, Moss SE. Visual impairment in diabetes. Ophthalmology. 1984 Jan;91(1):1-9.

National Society to Prevent Blindness. Vision Problems in the United States. Data analysis: definitions, data sources, detailed data tables, analysis, interpretation, 1980. In: NSPB Report. New York: National Society to Prevent Blindness; 1989: 1-46.

Dwyer MS, Melton J, Ballard DJ, Palumbo PJ, Trautmann JC, Chu CP. Incidence of diabetic retinopathy and blindness: a population based study in Rochester, Minnesota. Diabet Care. 1985;8(4):316-22.

Klein R, Klein BE, Moss SE, Davis MD, DeMets ML. The Wisconsin epidemiologic study of diabetic retinopathy. III Prevalence and risk of diabetic retinopathy when age at diagnosis is 30 or more years. Arch Ophthalmol. 1984;102:527-32.

Kempen JH, O'colmain BJ, Leske MC, Haffner SM, Klein R, Moss SE, et al. The prevalence of diabetic retinopathy among adults in the United States. Arch Ophthalmol. 2004 Apr;122(4):552-63.

Varghese A, Deepa R, Rema M, Mohan V. Prevalence of microalbuminuria in type 2 diabetes mellitus at a diabetes centre in Southern India. Postgrad Med J. 2001 Jun;77(908):399-402.

Moss SE, Meuer SM, Klein R, Hubbard LD, Brothers RJ, Klein BE. Are seven standard photographic fields necessary for classification of diabetic retinopathy? Invest Ophthalmol Vis Sci. 1989;30:823-8.

Early Treatment of Diabetic Retinopathy Study Research Group. Grading diabetic retinopathy from stereoscopic colour fundus photographs: an extension of the modified Airlie house classification. ETDRS report number 10. Ophthalmology. 1991;98:786-806.

Varma R, Torres M, Pena F, Klein R, Azen SP, The Los Angeles Latino Eye Study Group. Prevalence of diabetic retinopathy in adult Latinos: the Los Angeles Latino eye study. Ophthalmology. 2004;111:1298-306.

Chen MS, Kao CS, Chang CJ, Wu TJ, Fu CC, Chen CJ, et al. Prevalence and risk factors of diabetic retinopathy among noninsulin-dependent diabetic subjects. Am J Ophthalmol. 1992;114:723-30.

Broadbent DM, Scott JA, Vora JP, Harding SP. Prevalence of diabetic eye disease in an inner city population: the Liverpool diabetic eye study. Eye. 1999;13:160-5.