Erschienen in:
18.04.2023 | Clinical Investigation
Prevalence and severity of diabetic retinopathy at first presentation to vitreoretinal services in Bhutan: a 3-year national study
verfasst von:
Bhim Bahadur Rai, Rohan W. Essex, Michael G. Morley, Paul S. Bernstein, Joshua P. van Kleef, Ted Maddess
Erschienen in:
Japanese Journal of Ophthalmology
|
Ausgabe 3/2023
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Abstract
Purpose
To determine the prevalence and severity of diabetic retinopathy (DR) at first presentation among diabetic patients attending national vitreoretinal (VR) services in Bhutan
Study design
Retrospective cross-sectional study
Methods
We included all diabetic patients in Bhutan who presented for retinal evaluation for the first time over a 3-year period (2013–2016). Data including demography, clinical details, diagnostic tests, and clinical staging of DR were analyzed.
Results
A total of 843 diabetic patients, aged 57.2 ± 12.0 (range 18–86) years, were enrolled. The majority were male (452, 53.6%; cumulative frequency [cf] 391, 46.4%; P = .14) and from urban settings (570, 67.6%; cf 273; 32.4%) and did not have modern schooling (555, 65.8%). Hypertension was the most common systemic comorbidity (501, 59.4%). The prevalence of DR was 42.7%, with mild nonproliferative DR (NPDR) being the most common type (187, 51.9%), followed by moderate NPDR (88, 24.4%) and proliferative DR (45, 12.5%). In addition, 120 patients had clinically significant macular edema (CSME), with a prevalence of 14.2%. Best-corrected visual acuity (BCVA) of 6/60 or worse occurred in 231 eyes (13.7%), and 41 patients (4.86%) had BCVA of 6/60 or worse bilaterally due to DR/CSME. A logistic regression model indicated that the major determinant of DR was the duration of diabetes, the odds rising by 1.27× with each year of disease (P < .0001).
Conclusion
The prevalence of DR, including CSME, was high. Although a national DR screening program is established in Bhutan, there is a need to accelerate health education, community screening, and referral systems to reduce the prevalence of DR and CSME.