The profile of sight-threatening diabetic retinopathy in patients attending a specialist eye clinic in Hangzhou, China

Abstract

Background/aimsTo examine the profile of diabetic retinopathy, awareness and self-help in patients attending a specialist eye clinic in Hangzhou, China.MethodsA total of 199 consecutive patients with diabetes (mean age = 57 years, SD = 11) attending eye clinic at the School of Medicine, Zhejiang University, Hangzhou were examined in a cross-sectional study. Clinical/demographic data were obtained from patients’ records. Fundus photographs obtained from each patient were graded using Early Treatment of Diabetic Retinopathy Study (ETDRS) criteria; severe non-proliferative, proliferative retinopathy and/or macular oedema (hard exudates/thickening around fovea) were classified as sight-threatening diabetic retinopathy (STDR). Optical coherence tomography was used to confirm the diagnosis of macular oedema. Data on knowledge/awareness about diabetes and self-help/lifestyle were collected using a structured questionnaire.ResultsSTDR was found in 80% patients of whom 18% had visual acuity of ≤counting fingers in at least one eye. Male gender, longer diabetic duration and use of insulin were significantly associated with STDR (p ≤ 0.05). Of the total, 41% patients reported that they were attending for the first time. Of all the first-time attendees, 67% had STDR. Also of all the first-time attendees, 14% were unclear whether diabetes affected their eyes. Fifty-one per cent of patients who thought their diabetes was well controlled had fasting blood sugar ≥6.5 mmol/L (p < 0.001). Of the total, 65% patients reported not doing ≥4 hours/week of physical exercise.ConclusionsThe majority of patients with diabetes presented to this eye clinic suffered with late-stage retinopathy. Our results advocate the need to improve diabetic diagnosis, management and awareness and to set up eye screening for diabetics in Hangzhou, China.

Sight-threatening Diabetic Retinopathy and Associated Risk Factors Among Adult Diabetes Patients at Debre Tabor General Hospital, Northwest Ethiopia

“…Our finding demonstrated that, the likelihood of developing STDR was high for both types of DM participants with longer duration of diabetes (≥10 years) and this was consistent with what has been found previously in Norway, 32 Hangzhou, China, 27 mainland China, 20 India, 34 Cameroon, 41 and Malawi 29 that longer duration diabetes was associated with the development of visionthreatening diabetic retinopathy. This might be due the fact that in diabetes there are abnormalities in energy production which are thought to be the major contributor to the development of advanced diabetic complications like STDR, and these abnormalities are considered to occur late in the development of the disease.…”

“…Alternatively, our finding was lower than population-based studies done in Tanzania (23%), 26 besides the study setting the difference in the mean duration of diabetes contributed for this discrepancy. Similarly, our finding was also lower than Hangzhou, China (80%), 27 Fiji (27%), 28 and Malawi (29.4%). 29 The discrepancy could be attributed to the difference in study settings and duration of diabetes.…”

Knowledge and practices regarding diabetic retinopathy among diabetic patients registered in a chronic disease management system in eastern China

“…There are large variabilities in the reported knowledge level about DR in the literature: 37% in Australia, 65% in the USA and 27% in India [ 18 – 20 ]. A hospital-based study in Zhejiang and a community-based study in Liaoning, China reported that 67% and 68% of the study subjects, respectively, were unaware that diabetes can affect the eyes [ 21 , 22 ]. The differences among these studies could be partly explained by differences in health care systems, study populations and methods.…”

Prevalence and risk factors of diabetic retinopathy in diabetic patients

“…Different physical and clinical factors influence the risk of diabetic retinopathy. [ 11 ] In China, there is a significant lack of awareness of diabetes and its complications, which may affect eyes. [ 11 ] Also, the early detection of diabetic retinopathy helps in prevention and treatment.…”