FREQUENCY OF RETINOPATHY AMONG DIABETICS ADMITTED IN A TEACHING HOSPITAL OF LAHORE
Abstract
Background: Diabetic retinopathy is a complication of diabetes that affects the blood vessels of the retina and leads to blindness. Although 4 – 8 million diabetics exist in Pakistan, very little work has been done on this complication of diabetes. The present study was undertaken to estimate the frequency of retinopathy among diabetics admitted in a teaching hospital of Lahore. Methods: Every patient of diabetes mellitus, admitted in departments of Medicine, Surgery, Ophthalmology and Obstetrics & Gynecology at Sir Ganga RamHospital, Lahore between June 2001 and September 2001 was included in the study. After adequate mydriasis, detailed fundus examination using indirect opthalmoscope was carried out to determine the presence of diabetic retinopathy and its type. Results: Out of 4414 admissions, 540 patients – 340 females and 196 males were diabetics. Among 540 diabetics, 132 had Type-1 diabetes (24.4%) while 408 had Type-2 diabetes (75.6%). The duration of diabetes ranged from 10 to 12 years. The prevalence of diabetes among admitted patents was 12.2%. Among these 540 diabetics, 180 had diabetic retinopathy showing a prevalence of 33.3%. Non-proliferative retinopathy was present in 21.5% diabetics and proliferative retinopathy among 11.8% diabetics. The prevalence of retinopathy was significantly higher (P<0.001) among males (42.8%) as compared to females (27.9%). The prevalence was similar (33.3%) among both Type-1 as well as Type-2 diabetes as well as similar to that reported from other countries. Conclusion: Since 33.3% of our diabetic population is suffering from retinopathy – a condition amenable to timely and cost-effective treatment, every diabetic should be made aware of the importance of regular ophthalmologic examination.References
American Diabetes Association. Diabetic Retinopathy. Diabetes Care 2002;25:S90-S93
Mcleod BK, Thompson JR, Rosenthal AR. The prevalence of retinopathy in the insulin-requiring diabetic patients of an English country town. Eye 1988;2:424-430.
Amos AF, McCarty DJ, Zimmet P. The rising global burden of diabetes and its complications : estimates and projections to the year 2010. Diabetic Med 1997; 14 (Suppl) : S7-S85.
Pakistan Medical Research Council. National Health Survey of Pakistan, Islamabad: Pakistan Medical Research Council; 1997:54.
Shera AS, Rafique G, Khwaja IA, Baqai S, King H. Pakistan National Diabetes Survey: prevalence of glucose intolerance and associated factors in Baluchistan province. Diabetes Res Clin Pract 1999; 44: 49-58.
Shera AS, Rafique G, Khwaja IA, Ara J, Baqai S, King H. Pakistan national diabetes survey: prevalence of glucose intolerance and associated factors in Shikarpur, Sindh Province. Diabet Med 1995;12:1116-21.
Khan AJ. Prevalence of diabetic retinopathy in Pakistan subjects. A pilot study. J Pak Med Assoc 1991;41:49-50.
Wajid SA, Khan MD. Causes of irreversible blindness. J Coll Physicians Surg Pak 2001;11:561-5.
Klein R, Klein B, and Moss S. The Wisconsin Epidemiological Study of Diabetic Retinopathy: a review. Diabetes Metab Rev 1989; 5: 59-70.
Lairson DR, Pugh JA, Kapadia AS, Lorimor RJ, Jacobson J, Velez R. Cost- effectiveness of alternative methods for diabetic retinopathy screening. Diabetes Care 1992;15:1369-77.
Matz H, Falk M, Gottinger W, Kieslborch G. Cost-benefit analysis of diabetic eye disease. Ophthalmologica 1996; 210: 348-53.
James M, Turner DA, Broadbent DM, Vora J, Harding SP, Cost effectiveness analysis of screening for sight threatening diabetic eye disease. BMJ 2000; 320:1627-31.
Nadiaye MR, Cisse A, De Medeiros M, Wane A, Kameni A, Ndoye-Roth PA, Seye-Ndiaye C, Ba EH, Ndiaye PA, Wade A. Prevalence of diabetic retinopathy at the Dakar University Hospital Center. Dakar Med J 1999; 44:158-61.
Lopez IM, Diez A, Velilla S, Rueda A, Alvarez A, Pastor CJ. Prevalence of diabetic retinopathy and eye care in a rural area of Spain. Ophthalmic Epidemiol 2002;9:205-14.
El-Asrar AM, Al-Rubeaan KA, Al-Amro Sa, Kangave D, Moharram OA. Risk factors for diabetic retinopathy among Saudi Diabetics. Int Ophthalmolol 1998-99; 22:155-61.
Fernando Dj, Siribaddana S, De Silva, Subasinge Z. Prevalence of retinopathy in a Sri Lankan diabetes clinic. Ceylon Med J 1993; 38:120-3.
Gomes MB, Dorigo E, da Silva Junior GR, Goncalves MR, Neves R. Prospective study of development of microalbuminuria and retinopathy in Brazilian IDDM patients. Acta Diabetol 2000;37:19-25.
Herman WH, Aubert RE, Engelgau MM, Thompson TJ, Ali MA, Sous ES, et al. Diabetes mellitus in Egypt: glycaemic control and microvascular and neuropathic complications. Diabet Med 1998; 15:1045-51.
Singh SK, Behre A, Sing MK. Diabetic retinopathy and microalbuminuria in lean type 2 diabetes mellitus. J Assoc Physicians India 2001; 49:439-41.
Rotchford AP, Rotchford KM. Diabetes in rural South Africa-an assessment of care and complications. S Afr Med J 2002; 92:536-41.
Aiello LP, Gardiner TW, King GL, Blankenship G, Cavellerano JD, Ferris FL, et als: Diabetic Retinopathy (Technical Review). Diabetes Care 1998; 21:143-156.
Klein R, Klein BEK, Moss SE, Davis MD, DeMets KL. The Wisconsin Epidemiologic Study of Diabetic Retinopathy. Ophthalmology 1987; 94:747-753.
Kohner EM, Stratton IM, Aldington SJ, Holman RR, Matthews DR. UK Prospective Diabetes Study (UKPKDS) Group. Relationship between the severity of retinopathy and progression to photocoagulation in patients with Type 2 diabetes mellitus in the UKPDS (UKPDS 52). Diabet Med 2001; 18:178-84.
Issue
Section
License
Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.
USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.
AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.eu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.