Prevalence of Diabetic Retinopathy and Risk Factors Among Diabetic Patients at University of Gondar Tertiary Eye Care and Training Center, North-West Ethiopia. 

Abstract

Purpose: Diabetic retinopathy (DR) is one of the most serious complications of diabetes mellitus (DM). It is the most common cause of blindness among the working age group in the developed world and the fifth leading cause of global blindness. In Sub-Saharan Africa, 2.8% of all blindness is caused by DR. Studies addressing the patterns of DR and associated factors are scarce in Ethiopia. The objective of this study was to determine the Prevalence and associated factors of DR among DM patients attending University of Gondar (UOG), Tertiary Eye Care and Training center.Patients and methods: A cross-sectional study was carried out from March 2019 to February 2020 involving all consecutive diabetes patients who visited the center during the study period. Data were collected using a semi-structured questionnaire and data extraction check list, and entered into SPSS version 20 and analyzed. Univariate and multivariate logistic regression analysis were done to identify predictors of DR. Statistical significance was determined with 95% confidence interval using odds ratio and p-values.Results: A total of 225 DM patients with mean age of 55.4 ± 13.5 years were studied, of whom 95 (42.2%) had DR. Duration of diabetes ≥ 6 years (AOR= 2.91: 95%CI; 1.01-8.35) and baseline age < 60 years (AOR= 3.2: 95%CI; 1.19 - 8.63) were significantly associated with DR. Diabetic retinopathy was significantly associated with the form of therapy. Those on insulin (p=0.025), and oral hypoglycemic agents (OHA) with insulin combination (p=0.014) had statistically significantly associated with development of DR. Patients with systolic blood pressure of <140 mmHg were 3.6 times (AOR=0.28:95%CI:0.09-0.82) less likely to have DR. A majority of patients had Non-proliferative DR (NPDR) without diabetic macular edema (DME) (34.2%). DME and proliferative DR (PDR) were seen in 5.7% and 3.6% of the patients respectively. Vision threatening DR (VTDR) was seen in 10.7% of patients. There was significant association between age <60 years and VTDR (AOR=4.19: 95%CI; 1.23-14.35).Conclusion: The prevalence of DR among our study patients was very high. Longer duration of diabetes, higher systolic blood pressure, baseline age < 60 years, use of insulin alone and use of combination of insulin with OHA were independently associated with DR. Health education; early screening and treatment are recommended.

Prevalence of diabetic macular edema and risk factors among diabetic patients at the University of Gondar Tertiary Eye Care and Training Center, North West Ethiopia

“…A majority of participants in this study,79.4%, were type-II DM patients and this is similar with previous studies done in Ethiopia, 88.4% in Gondar, 72.8% in Jimma and 60.92% Debre marcos (10,11,28,29)…”

“…However, the reported prevalence of DME in previous studies in this region of NW Ethiopia, 11%, 6.4% and 5.7%, is lower than our report and this may be because of the differences in the study setting, method of data collection and sample size. (10,11,29) Similar diabetic clinic based studies in Cameroon 8% and in South Africa 12.5%, also reported a lower prevalence of DME than ours. (6,7)…”

“…A majority of participants in this study,79.4%, were type-II DM patients and this is similar with previous studies done in Ethiopia, 88.4% in Gondar, 72.8% in Jimma and 60.92% Debre marcos (10,11,28,29) Longer duration of DM was strongly associated with diabetic macular edema in many studies. (2,3,10,11) However our study did not find association between duration of diabetes with development of DME and this may be because nearly half of our study patients, 44.8%, had duration of diabetes less than five years.…”

“…The prevalence of diabetic retinopathy in this study 33.3% is higher than diabetic clinic based previous reports from this region 16 % (10) and 18.9 % (29) however a study done in Jimma South West Ethiopia and another study done in NW Ethiopia reported higher figures than this study, 42.2% and 41.4% respectively. (11,28) This may be due to the differences in data collection technique, sample size and study setting.…”

“…In Ethiopia, the prevalence ranges from 5.7% to 11%. (10,11) Different factors have been found to be associated with DME including type-I diabetes (12,13,14) poor glycemic control (15,16,17,18), longer duration of DM (1,3,12,16), systemic hypertension (3,8,13,16,17,18,19) , dyslipidemia (12,20), insulin therapy (3,6), proteinuria (3,15,20) and cataract surgery (15,17,21).…”