No abstract

Background Diabetes mellitus is a complex metabolic disorder characterized by hyperglycemia that results from defects in insulin secretion, insulin action, or both. Glaucoma is the ocular complication of diabetic illness. In addition to this, retinopathy, maculopathy, ischemic optic neuropathy, extra-ocular muscle palsy, iridocyclitis, and rubeosis iridis were other complications. This study aims to determine the impact of diabetes on visual impairment and blindness among diabetic patients in Ethiopia. Methods This hospital-based cross-sectional study includes 401 samples of diabetic patients in the University of Gondar Comprehensive Specialized Hospital from January 2017 to January 2019. The multinomial logistic regression model was employed to identify significant differences among the factor variables. Results The magnitude of blindness was 32.17%, and the burden of severe visual impairment was 12.46%. Of the total patients, 120(29.9%) were have diabetic retinopathy of whom, 113(94.2%) were blind either in the right, left, or both eyes and 3 (2.5%) had severe visual impairment. One hundred twenty-six (31.42%) patients developed diabetic maculopathy of whom, 117 (92.85%) were blind either in the right or left eye, and one (0.8%) had severe visual impairment. From the whole diabetic patients, the magnitude of glaucoma was 186(46.38%), and from the patients who developed glaucoma was blind visual impairment 127(68.27%) either in the right or left eye. Thirty-eight (20.34%) had severe visual impairment. Glaucoma was significantly associated with severe visual impairment and blindness (p<0.001). Glaucoma, diabetic retinopathy, maculopathy, and type of diabetes are factors for visual impairment. Conclusion We found that visual impairment in the category of severe and blindness are frequent in Ethiopian diabetic patients. Glaucoma, diabetic retinopathy, maculopathy are the main predictive factors that determine the occurrence of blindness.

The objective of the study was to identify the best-fitted survival regression model and to find factors that accelerate the time of blindness of glaucoma patients in University of Gondar Comprehensive Specialized Hospital. Material and Methods: Secondary data was taken from the patient's card, collected from January 2014-April 2018 in the hospital. In this study 401 glacoma patients' record was considered. Kaplan-Meier survival analysis, Semiparametric and Parametric AFT model were applied to identify factors that lead blindness of glaucoma patients. Results: From the total 401 glaucoma patients 23.69% was blind. From the total sample 38.41% and 61.59% were female and male glaucoma patients, respectively. The median time of blindness for the two eyes or one eye was 16 months after confirmation of glaucoma disease. In the multivariable Weibull accelerated failure-time model it has found that age group (18-43) (TR =1.29233, CI: 1.039576 to 1.606536), advanced stage of glaucoma (TR =1.281674, CI: 1.096103 to 1.498662), duration of diagnosis 1-5 years (TR = 1.944649, CI: 1.332738 to 2.83751) and duration of diagnosis >= 6 years (TR = 2.683586, CI: 1.367533 to 5.26615) were significantly associated with the time to blindness. Conclusion: The multivariable Weibull model revealed that age, duration of diagnosis and stage of glaucoma were major factors that affect the survival probability of glaucoma patients. Finally, based on the results of the study we can conclude that the Weibull regression model was the best fitted parametric accelerated failure-time model for identifying the major factors related to glaucoma patients.