1
|
Hinneh T, Akyirem S, Bossman IF, Lambongang V, Ofori-Aning P, Ogungbe O, Commodore Mensah Y. Regional prevalence of hypertension among people diagnosed with diabetes in Africa, a systematic review and meta-analysis. PLOS Glob Public Health 2023; 3:e0001931. [PMID: 38051707 PMCID: PMC10697518 DOI: 10.1371/journal.pgph.0001931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 11/03/2023] [Indexed: 12/07/2023]
Abstract
Hypertension and diabetes comorbidity can increase healthcare expenditure and the risk of coronary heart disease. We conducted a systematic review and meta-analysis to estimate the prevalence of hypertension among people with diabetes in African countries. We searched EMBASE, PubMed and HINARI databases from inception to March 2023. Cross-sectional studies reporting the prevalence of hypertension among people with diabetes and published in English in Africa were eligible for inclusion. The cross-sectional study design component of the mixed method appraisal tool was used to assess the quality of the included studies. We quantified the overall and regional prevalence of hypertension among people with diabetes using random-effects meta-analysis. We assessed heterogeneity and publication bias using I2 statistics and funnel plots. Out of 3815 articles retrieved from the various databases, 41 met the inclusion criteria with sample sizes ranging from 80 to 116726. The mean age was 58 years (± 11) and 56% were women. The pooled prevalence of hypertension in people diagnosed with diabetes was 58.1% [95% CI: 52.0% - 63.2%]. By region, Central Africa had the highest hypertension prevalence; 77.6% [95% CI: 53.0% - 91.4%], Southern Africa 69.1% [95% CI: 59.8% - 77.1%;], North Africa 63.4% [95% CI: 37.1% - 69.1%;], West Africa 51.5% [95% CI: 41.8% - 61.1%] and East Africa 53.0% [95% CI: 45.8% - 59.1%]. Increasing age, being overweight/obese, being employed, longer duration of diabetes, urban residence, and male sex were reported to be associated with a higher likelihood of developing hypertension. The high prevalence of hypertension among people with diabetes in Africa highlights the critical need for an integrated differentiated service delivery to improve and strengthen primary care and prevent cardiovascular disease. Findings from this meta-analysis may inform the delivery of interventions to prevent premature cardiovascular disease deaths among persons in the region.
Collapse
Affiliation(s)
- Thomas Hinneh
- Johns Hopkins University School of Nursing, Baltimore, Maryland, United States of America
| | - Samuel Akyirem
- Yale School of Nursing, Yale University, New Haven, Connecticut, United States of America
| | | | - Victor Lambongang
- School of Health Sciences, Liberty University, Lynchburg, Virginia, United States of America
| | - Patriot Ofori-Aning
- Department of Medicine for Older People, Stockport NHS Foundation Trust, Manchester, United Kingdom
| | - Oluwabunmi Ogungbe
- Johns Hopkins University School of Nursing, Baltimore, Maryland, United States of America
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Yvonne Commodore Mensah
- Johns Hopkins University School of Nursing, Baltimore, Maryland, United States of America
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| |
Collapse
|
2
|
Ashenef B, Diress M, Yeshaw Y, Dagnew B, Gela YY, Akalu Y, Abdurahman A, Abebaw K. Visual Impairment and Its Associated Factors Among Hypertensive Patients in Amhara Region Referral Hospitals, Ethiopia. Clin Ophthalmol 2023; 17:3149-3161. [PMID: 37881781 PMCID: PMC10597370 DOI: 10.2147/opth.s408171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 08/04/2023] [Indexed: 10/27/2023] Open
Abstract
Background Visual impairment is one of the most common long-term effects of high blood pressure. It affects one's quality of life, independence, and mobility. There is a paucity of information regarding the prevalence of visual impairment due to hypertension in Ethiopia. Therefore, this study aimed to determine the prevalence of visual impairment and its associated factors among hypertensive patients in referral hospitals of the Amhara region, Ethiopia, 2021. Methods An institution-based cross-sectional study was conducted among 423 study participants, which were selected by systematic random sampling technique. Data were collected by using an interviewer-administered structured questionnaire and physical measurements. The collected data were entered into Epi-data version 4.6. Then, exported into SPSS Version 26 for analysis. The crude and adjusted odds ratios and 95% Confidence intervals were calculated. Both bivariable and multivariable logistic regression analyses were done. Variables with a p-value of ≤0.05 were stated as significantly associated with visual impairment. Results The overall prevalence of visual impairment among hypertensive patients was 32.4% (95% CI: 27.9-37.9). Duration of hypertension ≥ 5 years (AOR =3.06, 95% CI: 1.86-4.95), history of ocular trauma (AOR =2.50, 95% CI: 1.3-4.73), and ever alcohol drinking (AOR = 2.72, 95% CI: 1.32-5.62) were significantly associated with visual impairment. Conclusion Nearly one-third of hypertensive patients were visually impaired from the study participants. Duration of hypertension ≥5 years, history of ocular trauma, and ever alcohol drinking was significantly associated with visual impairment among hypertensive patients. Therefore, in addition to providing medical care and follow-up services for hypertension patients, health education is needed for early and proper management of visual impairment, and to decrease their level of alcohol consumption. Furthermore, better to do this study by prospective cohort study design to identify cause-and-effect relationships.
Collapse
Affiliation(s)
- Baye Ashenef
- Department of Human Physiology, School of Medicine, Debre Markos University, Debre Markos, Ethiopia
| | - Mengistie Diress
- Department of Human Physiology, School of Medicine, University of Gondar, Gondar, Ethiopia
| | - Yigizie Yeshaw
- Department of Human Physiology, School of Medicine, University of Gondar, Gondar, Ethiopia
| | - Baye Dagnew
- Department of Human Physiology, School of Medicine, University of Gondar, Gondar, Ethiopia
| | - Yibeltal Yismaw Gela
- Department of Human Physiology, School of Medicine, University of Gondar, Gondar, Ethiopia
| | - Yonas Akalu
- Department of Human Physiology, School of Medicine, University of Gondar, Gondar, Ethiopia
| | - Abdulhenan Abdurahman
- Department of Human Physiology, School of Medicine, Madda Walabu University, Bale Goba, Ethiopia
| | - Kassa Abebaw
- Department of Human Physiology, School of Medicine, Debre Markos University, Debre Markos, Ethiopia
| |
Collapse
|
3
|
Zegeye AF, Temachu YZ, Mekonnen CK. Prevalence and factors associated with Diabetes retinopathy among type 2 diabetic patients at Northwest Amhara Comprehensive Specialized Hospitals, Northwest Ethiopia 2021. BMC Ophthalmol 2023; 23:9. [PMID: 36604682 PMCID: PMC9814297 DOI: 10.1186/s12886-022-02746-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 12/16/2022] [Indexed: 01/06/2023] Open
Abstract
INTRODUCTION The worldwide prevalence of Diabetic Retinopathy was recently estimated to be 34.6%. The prevalence of diabetic retinopathy in developed nations has been thoroughly investigated, and risk factors are well understood. However, there is a shortage of information in the study areas about the prevalence and contributing factors of diabetic retinopathy among type two diabetes patients. OBJECTIVE The aim of this study was to assess the prevalence of diabetic retinopathy and associated factor among type 2 diabetic patients who were on follow up services at northwest Amhara comprehensive specialized hospitals diabetic care units. METHOD An institutional based cross-sectional study was conducted at northwest Amhara comprehensive specialized hospitals from October 15 to November 15, 2021, among 496 diabetes patients. Systematic random sampling technique was used. Data were collected by utilizing a semi-structured questionnaire and a direct Topcon retinal camera inspection. Then data were coded, entered, and exported to SPSS version 23 from EPI-Data version 4.6. All variables with P-value < 0.25 in the binary logistic regression analyses were included in the multivariable regression analysis. The degree of association was interpreted by using the adjusted odds ratio with 95% confidence intervals, and the significance level was declared at P-value < 0.05. The Hosmer-Lemeshow test was used to check the fitness of the model. RESULT The prevalence of diabetic retinopathy among type two diabetes patients was 36.3%. Sex [AOR = 3.25, 95% CI (1.80, 6.68)], visiting health institution [AOR = 0.027, 95% CI (0.003, 0.253)], educational level [AOR = 4.23, 95% CI (1.09, 16.47)], glycemic control [AOR = 0.099, 95% CI (0.02, 0.49)], hypertension status (AOR = 2.56, 95% CI (1.01, 6.45)] were significantly associated with diabetic retinopathy. CONCLUSION In this study less than half of diabetic patients had diabetic retinopathy. Sex, visiting health institution, educational level, glycemic control, and hypertension status were significantly associated with diabetic retinopathy.
Collapse
Affiliation(s)
- Alebachew Ferede Zegeye
- grid.59547.3a0000 0000 8539 4635Department of Medical Nursing, School of Nursing, University of Gondar, P.O.Box 196, Gondar, Ethiopia
| | - Yemataw Zewdu Temachu
- grid.59547.3a0000 0000 8539 4635Department of Emergency and Critical Care, School of Nursing, University of Gondar, P.O.Box 196, Gondar, Ethiopia
| | - Chilot Kassa Mekonnen
- grid.59547.3a0000 0000 8539 4635Department of Medical Nursing, School of Nursing, University of Gondar, P.O.Box 196, Gondar, Ethiopia
| |
Collapse
|
4
|
Demilew KZ, Adimassu NF, Alemu DS. Visual Impairment Among Adult Diabetic Patients and Associated Factors at Debre Brihan Referral Hospital, Central Ethiopia, 2017. Middle East Afr J Ophthalmol 2022; 29:19-26. [PMID: 36685341 PMCID: PMC9846958 DOI: 10.4103/meajo.meajo_459_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 07/05/2021] [Accepted: 06/06/2022] [Indexed: 01/24/2023] Open
Abstract
PURPOSE The study aimed to assess the proportion of visual impairment and associated factors among diabetic patients at Debre Berhan Referral Hospital (DBRH). METHODS A hospital-based cross-sectional study was carried out from April 27 to May 19, 2017. All adult diabetic patients attending DBRH during the study period were included in the study. A pretested, structured questionnaire and clinical examinations were used for data collection. The collected data were entered into Epi Info 7 and exported to the Statistical Package for Social Sciences version 20 for analysis. The descriptive analysis was summarized by frequency, percent, and summary statistics. Association between visual impairment and independent variables was determined via bivariable and multivariable binary logistic regressions. P < 0.05 was considered statistically significant. Adjusted odds ratio (AOR) and 95% confidence interval (CI) were used to determine the strength of association. Hosmer and Lemeshow goodness of fit was used to check for model fitness. RESULTS A total of 388 study subjects with a 92% response rate took part in the study. The prevalence of visual impairment was 29.38% (95% CI: 24.83%-33.93%). Age >56 years (AOR = 5.24, 95% CI: 1.37-20.04), physical inactivity (AOR = 2.34, 95% CI: 1.33-4.14), presence of visual symptoms (AOR = 4.48, 95% CI: 2.35-8.57), lower body mass index (AOR = 6.23, 95% CI: 1.87-20.68), and diabetic retinopathy (AOR = 5.12, 95% CI: 1.91-13.70) had a statistically significant association with visual impairment. CONCLUSION A high proportion of diabetic patients had visual impairment. Independent variables older age, physical inactivity, presence of visual symptoms, lower body mass index, and diabetic retinopathy had a positive statistically significant association with visual impairment.
Collapse
Affiliation(s)
- Ketemaw Z. Demilew
- Department of Optometry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia,Address for correspondence: Mr. Ketemaw Z. Demilew, Department of Optometry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia. E-mail:
| | - Nebiyat F. Adimassu
- Department of Optometry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Destaye S. Alemu
- Department of Optometry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| |
Collapse
|
5
|
Mersha GA, Alimaw YA, Belete GT, Woredekal A. Prevalence, Cause, and Associated Factors of Visual Impairment Among Diabetic Patients at the Debre Tabor General Hospital, Northwest Ethiopia. Journal of Visual Impairment & Blindness 2022. [DOI: 10.1177/0145482x221131823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Introduction: Visual impairment is a major public health challenge for diabetics who have ocular comorbidities. In Ethiopia, data are lacking on the prevalence of visual impairment among diabetics as well as information on causes and predisposing factors. The current study was designed to assess the causes, risk factors, and levels of diabetes-related visual impairment within an Ethiopian population. Methods: The study enrolled a total of 296 diabetic patients at the Debre Tabor General Hospital (DTGH). Data were ascertained through face-to-face interview, from patients’ medical folder, and through comprehensive ocular health assessment. Descriptive and analytical statistics were performed. Result: Generally, the prevalence of visual impairment among adult diabetic patients was 39.5% (95% confidence interval [CI]: 33.8–45.6). Visual impairment was primarily due to diabetic retinopathy (44.4%), followed by refractive error (20.6%), cataract (13.9%), other ocular conditions (6.1%), and glaucoma (5.4%). Age >45 years (adjusted odds ratio [AOR] = 7.8, 95% CI: 3.5–18), female gender (AOR = 3.0, 95% CI: 1.4–7.7), low educational status (AOR = 8.1, 95% CI: 2.4–26.0), and longer span of diabetes (AOR = 3.7, 95% CI: 2.1–6.8) had a notable association with visual impairment among diabetic patients. Discussion: This study observed a high prevalence of visual impairment in diabetic patients. Diabetic retinopathy, refractive error, and cataract were the most common causes of visual impairment, followed by other ocular conditions and glaucoma. Older age, female gender, low educational status, and longer span of diabetes were important risk factors of visual impairment among diabetic patients. Implications for Practitioners: This result could alert health care professionals to inform their diabetic clients about the serious impacts of diabetes and the need for a regular eye check-up. Health care providers and policy makers should work to integrate the diabetic clinics into a general hospital with an eye care unit for an effective screening of diabetic eye disease and prevention of blindness.
Collapse
Affiliation(s)
- Getasew Alemu Mersha
- Department of Optometry, College of Medicine and Health Sciences, School of Medicine, Comprehensive Specialized Hospital, University of Gondar, Gondar, Ethiopia
| | - Yezinash Addis Alimaw
- Department of Optometry, College of Medicine and Health Sciences, School of Medicine, Comprehensive Specialized Hospital, University of Gondar, Gondar, Ethiopia
| | - Gizachew Tilahun Belete
- Department of Optometry, College of Medicine and Health Sciences, School of Medicine, Comprehensive Specialized Hospital, University of Gondar, Gondar, Ethiopia
| | - AsamereTsegaw Woredekal
- Department of Ophthalmology, School of Medicine, Comprehensive Specialized Hospital, University of Gondar, Gondar, Ethiopia
| |
Collapse
|
6
|
Kibirige D, Chamba N, Andia-Biraro I, Kilonzo K, Laizer SN, Sekitoleko I, Kyazze AP, Ninsiima S, Ssekamatte P, Bongomin F, Mrema LE, Olomi W, Mbunda TD, Ntinginya NE, Sabi I, Sharples K, Hill P, Te Brake L, VandeMaat J, vanCrevel R, Critchley JA. Indicators of optimal diabetes care and burden of diabetes complications in Africa: a systematic review and meta-analysis. BMJ Open 2022; 12:e060786. [PMID: 36351737 PMCID: PMC9644326 DOI: 10.1136/bmjopen-2022-060786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVE Contemporary data on the attainment of optimal diabetes treatment goals and the burden of diabetes complications in adult populations with type 2 diabetes in Africa are lacking. We aimed to document the current status of attainment of three key indicators of optimal diabetes care and the prevalence of five diabetes complications in adult African populations with type 2 diabetes. METHODS We systematically searched Embase, PubMed and the Cochrane library for published studies from January 2000 to December 2020. Included studies reported any information on the proportion of attainment of optimal glycated haemoglobin (HbA1c), blood pressure (BP) and low-density lipoprotein cholesterol (LDLC) goals and/or prevalence of five diabetes complications (diabetic peripheral neuropathy, retinopathy, nephropathy, foot ulcers and peripheral arterial disease). Random effect model meta-analysis was performed to determine the pooled proportion of attainment of the three treatment goals and the prevalence of five diabetes complications. RESULTS In total, 109 studies with a total of 63 890 participants (53.3% being females) were included in the meta-analysis. Most of the studies were conducted in Eastern African countries (n=44, 40.4%). The pooled proportion of attainment of an optimal HbA1c, BP and LDLC goal was 27% (95% CI 24 to 30, I2=94.7%), 38% (95% CI 30 to 46, I2=98.7%) and 42% (95% CI 32 to 52, I2=97.4%), respectively. The pooled prevalence of diabetic peripheral neuropathy, retinopathy, diabetic nephropathy, peripheral arterial disease and foot ulcers was 38% (95% CI 31 to 45, I2=98.2%), 32% (95% CI 28 to 36, I2=98%), 31% (95% CI 22 to 41, I2=99.3%), 19% (95% CI 12 to 25, I2=98.1%) and 11% (95% CI 9 to 14, I2=97.4%), respectively. CONCLUSION Attainment of optimal diabetes treatment goals, especially HbA1c, in adult patients with type 2 diabetes in Africa remains a challenge. Diabetes complications, especially diabetic peripheral neuropathy and retinopathy, are highly prevalent in adult populations with type 2 diabetes in Africa.
Collapse
Affiliation(s)
- Davis Kibirige
- Department of Medicine, Lubaga Hospital, Kampala, Uganda
| | - Nyasatu Chamba
- Department of Internal Medicine, Kilimanjaro Christian Medical Centre, Moshi, Kilimanjaro, Tanzania
- Department of Medicine, Kilimanjaro Christian Medical University College, Moshi, Kilimanjaro, Tanzania
| | - Irene Andia-Biraro
- Department of Internal Medicine, Makerere University College of Health Sciences, Kampala, Uganda
- Department of Immunomudation and Vaccines, MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda
| | - Kajiru Kilonzo
- Department of Internal Medicine, Kilimanjaro Christian Medical Centre, Moshi, Kilimanjaro, Tanzania
- Department of Medicine, Kilimanjaro Christian Medical University College, Moshi, Kilimanjaro, Tanzania
| | - Sweetness Naftal Laizer
- Department of Medicine, Kilimanjaro Christian Medical University College, Moshi, Kilimanjaro, Tanzania
| | - Isaac Sekitoleko
- Non-Communicable Diseases Program, Medical Research Council/Uganda Virus Research Institute & London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda
| | - Andrew Peter Kyazze
- Department of Internal Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - Sandra Ninsiima
- Department of Immunology, Makerere University College of Health Sciences, Kampala, Uganda
| | - Phillip Ssekamatte
- Department of Immunology, Makerere University College of Health Sciences, Kampala, Uganda
| | - Felix Bongomin
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Gulu University, Gulu, Uganda
| | - Lucy Elauteri Mrema
- Department of Medicine, NIMR-Mbeya Medical Research Programme, Mbeya, Mbeya, Tanzania
| | - Willyhelmina Olomi
- Department of Medical Statistics, NIMR-Mbeya Medical Research Programme, Mbeya, Mbeya, Tanzania
| | - Theodora D Mbunda
- Department of Medicine, NIMR-Mbeya Medical Research Programme, Mbeya, Mbeya, Tanzania
| | | | - Issa Sabi
- Department of Paediatrics and Child Health, NIMR-Mbeya Medical Research Programme, Mbeya, Tanzania
| | - Katrina Sharples
- Centre for International Health, University of Otago, Dunedin, New Zealand
| | - Philip Hill
- Centre for International Health, University of Otago, Dunedin, New Zealand
| | - Lindsey Te Brake
- Department of Pharmacology, Radboud University Nijmegen, Nijmegen, Gelderland, The Netherlands
| | - Josephine VandeMaat
- Department of Medicine, Radboud University Nijmegen, Nijmegen, Gelderland, The Netherlands
| | - Reinout vanCrevel
- Department of Internal Medicine, Radboud University Nijmegen, Nijmegen, Gelderland, The Netherlands
- University of Oxford Centre for Tropical Medicine and Global Health, Oxford, Oxfordshire, UK
| | | |
Collapse
|
7
|
Heiran A, Azarchehry SP, Dehghankhalili S, Afarid M, Shaabani S, Mirahmadizadeh A. Prevalence of diabetic retinopathy in the Eastern Mediterranean Region: a systematic review and meta-analysis. J Int Med Res 2022; 50:3000605221117134. [PMID: 36314851 PMCID: PMC9629581 DOI: 10.1177/03000605221117134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Objectives Individual studies in the Eastern Mediterranean Region (EMR) have shown the high prevalence of diabetic retinopathy. We conducted a meta-analysis to yield an estimate of the prevalence of diabetic (type 1 and 2) retinopathy in the EMR. Additionally, we explored its potential modulators. Methods Two-step screening of relevant articles published from 1 January 2000 to 13 December 2019 was carried out. An estimation of summary proportions, subgroup analysis, meta-regression, and publication bias assessment were performed. Results One hundred nine articles were included in the meta-analysis, involving 280,566 patients. The prevalence of diabetic retinopathy was 31% (95% confidence interval [CI] = 28, 33). The highest and lowest diabetic retinopathy prevalence rates were observed in low human development index (HDI) countries (63.6; 95% CI = 52.4, 74.0) and very high HDI countries 22.6 (95% CI = 20.5, 24.7), respectively. Conclusions The prevalence of diabetic retinopathy is high in the EMR. Our results provide important information for diverse healthcare surveillance systems in the EMR to implement the modifiable risk factors, diabetes screening to decrease undiagnosed diabetes, early detection of retinopathy, and proper diabetes care to decrease untreated diabetes.
Collapse
Affiliation(s)
- Alireza Heiran
- Non-communicable Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran,Alireza Mirahmadizadeh, Non-communicable Diseases Research Center, Shiraz University of Medical Sciences, Zand Blvd, Shiraz, Iran. PO: 7193635899.
| | - Seyede Pegah Azarchehry
- Department of Biochemistry, Faculty of Biological Sciences, Tarbiat Modares University, Tehran, Iran
| | | | - Mehrdad Afarid
- Poostchi Ophthalmology Research Center, Department of Ophthalmology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sonia Shaabani
- Alzahra Cardiovascular Charitable Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Alireza Mirahmadizadeh
- Non-communicable Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| |
Collapse
|
8
|
Alemayehu HB, Tegegn MT, Tilahun MM. Prevalence and associated factors of visual impairment among adult diabetic patients visiting Adare General Hospital, Hawassa, South Ethiopia, 2022. PLoS One 2022; 17:e0276194. [PMID: 36227943 PMCID: PMC9560493 DOI: 10.1371/journal.pone.0276194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 09/30/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The increased prevalence of visual impairment among diabetic patients has become a major public health problem. However, there was limited information on the extent of visual impairment among diabetic patients in our country, and there was no study in the study area. Providing updated data regarding this area is critical for the prevention of visual impairment among diabetic patients. PURPOSE The study aimed to assess the prevalence and associated factors of visual impairment among adult diabetic patients visiting Adare General Hospital, Hawassa, South Ethiopia, 2022. METHODS A hospital-based cross-sectional study was conducted on adult diabetic patients from May 30 to July 15, 2022, at Adare General Hospital, Hawassa, South Ethiopia. A systematic random sampling method was used to select 398 study participants. Data was collected through a face-to-face interview, a medical chart review, and an ocular examination. A binary logistic regression was performed to identify potential risk factors for visual impairment and their strength of association was expressed using an adjusted odds ratio with a 95% confidence interval. Variables with a P-value of < 0.05 were considered statistically significant. RESULT In this study, a total of 391 participants were involved, with a response rate of 98.2%. The prevalence of visual impairment was 28.6% (95% CI: 24.6-33.0). Age ≥ 60 years (AOR = 4.03, 95% CI: 1.72, 10.71), poor physical exercise (AOR = 3.26, 95% CI: 1.62, 6.53), poor glycemic control (AOR = 4.34, 95% CI: 2.26, 8.34), history of eye examination (AOR = 2.94, 95% CI: 1.50, 5.76), duration of diabetes ≥ 9 years (AOR = 4.78, 95% CI: 2.11, 10.83) and diabetic peripheral neuropathy (AOR = 3.01, 95% CI: 1.21, 7.50) were positively associated with visual impairment. CONCLUSION The study found a high prevalence of visual impairment among adult diabetic patients. Older age, longer duration of diabetes, poor physical exercise, poor glycemic control, history of eye examination, and diabetic peripheral neuropathy were significantly associated with visual impairment. Thus, regular physical activity, good control of glucose levels, and regular eye exams were recommended for all diabetic patients.
Collapse
Affiliation(s)
- Henok Biruk Alemayehu
- Department of Ophthalmology and Optometry, Collage of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Melkamu Temeselew Tegegn
- Department of Optometry, School of Medicine, University of Gondar, Comprehensive Specialized Hospital, Gondar, Ethiopia
| | - Mikias Mered Tilahun
- Department of Optometry, School of Medicine, University of Gondar, Comprehensive Specialized Hospital, Gondar, Ethiopia
- * E-mail:
| |
Collapse
|
9
|
Shrestha P, Kaiti R, Shyangbo R. Blindness among Patients with Type II Diabetes Mellitus Presenting to the Outpatient Department of Ophthalmology of a Tertiary Care Centre: A Descriptive Cross-sectional Study. JNMA J Nepal Med Assoc 2022; 60:877-880. [PMID: 36705156 PMCID: PMC9924922 DOI: 10.31729/jnma.7702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 09/03/2022] [Indexed: 11/07/2022] Open
Abstract
Introduction Diabetic retinopathy is a major microvascular complication of diabetes, and may progress to sight-threatening stages causing blindness with a consequent decrease in their quality of life. This study aimed to find out the prevalence of blindness among patients with type II diabetes mellitus attending the Outpatient Department of Ophthalmology of a tertiary care hospital. Methods A descriptive cross-sectional study was conducted among patients with type II diabetes mellitus presenting to the Outpatient Department of Ophthalmology of a tertiary care centre from 2 August 2021 to 30 June 2022 after receiving ethical approval from the Institutional Review Committee (Reference number: 74/2021). Diabetic patients underwent detailed eye examination including vision, slit lamp biomicroscopy examination, and fundus evaluation with full pupil dilation. Convenience sampling method was used. Point estimate and 95% Confidence Interval were calculated. Results Among 449 type II diabetic patients, blindness was seen in 17 (3.79%) (2.02-5.56, 95% Confidence Interval) patients. Among them, 1 (5.88%) had severe non-proliferative diabetic retinopathy, 3 (17.65%) had proliferative diabetic retinopathy and 8 (47.06%) had severe diabetic macular oedema. Conclusions The prevalence of blindness among patients with type II diabetes mellitus was less than in other studies conducted in similar settings. Screening and timely management of diabetic retinopathy could reduce the prevalence of blindness due to diabetic retinopathy. Keywords blindness; diabetic retinopathy; prevalence.
Collapse
Affiliation(s)
- Pooja Shrestha
- Department of Ophthalmology, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal,Correspondence: Dr Pooja Shrestha, Department of Ophthalmology, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal. , Phone: +977-9851082192
| | - Raju Kaiti
- Department of Optometry, Nepal Eye Hospital, Tripureshwor, Kathmandu, Nepal
| | - Ranjila Shyangbo
- Department of Optometry, National Academy of Medical Sciences, Mahaboudha, Kathmandu, Nepal
| |
Collapse
|
10
|
Gari FS, Gelcho GN. Bivariate Survival Copula Analysis of Glaucoma Patients during Blindness: Glaucoma Cases at Alert Hospital in Addis Ababa City of Ethiopia. J Res Health Sci 2022; 22:e00547. [PMID: 36511259 PMCID: PMC9818039 DOI: 10.34172/jrhs.2022.82] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 04/26/2022] [Accepted: 04/17/2022] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Glaucoma is a worldwide problem that causes vision loss and even blindness, with a prevalence rate ranging from 1.9% to 15%. In Ethiopia, glaucoma is the fifth cause of blindness. This study aimed to explore the dependence between blindness of the right and the left eyes of glaucoma patients and assess the effects of the covariates under the dependence structure. STUDY DESIGN A retrospective cohort study. METHODS The study population included the glaucoma patients at Alert hospital from January 1, 2018, to December 30, 2021. The copula model was used to estimate the time to the blindness of the right and the left eyes of the glaucoma patients by specifying the dependence between the event times. RESULTS Out of 537 glaucoma patients, 224 (41.71%) became blind at least in one eye during the follow-up period. The results of the Clayton copula model revealed that factors, such as age, residence, diabetes mellitus, stage of glaucoma, and hypertension are considered the most prognostic factors for blindness in glaucoma patients. The findings also revealed that there was a strong dependence between the time to the blindness of the right and the left eyes in the glaucoma patients (τ = 0.43). CONCLUSION Based on the obtained results, high age, urban residence, hypertension, diabetes mellitus, and higher stage of glaucoma were factors associated with time to the blindness in the glaucoma patients. There was also a dependence between the right and the left eyes of the glaucoma patients. The results revealed that the Clayton Archimedean copula model was the best statistical model for accurate description of glaucoma patients' datasets.
Collapse
Affiliation(s)
- Firomsa Shewa Gari
- Department of Statistics, College of Natural and Computational Science, Assosa University, Assosa, Ethiopia
| | - Gurmessa Nugussu Gelcho
- Department of Statistics, College of Natural Science, Jimma University, Jimma, Ethiopia,Corresponding author: Gurmessa Nugussu (MSc) Tel:+25 1912007548
| |
Collapse
|
11
|
Chai S, Ge Y, Wan Y, Xia H, Dong R, Ren X, Yuan H, Hou Q, Yang J, Li X. Visual functional defects in patients with type 2 diabetes mellitus: a questionnaire based cross-sectional study. Int Ophthalmol 2022; 42:2205-2218. [PMID: 35119607 DOI: 10.1007/s10792-022-02220-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Accepted: 01/06/2022] [Indexed: 11/24/2022]
Abstract
PURPOSE To determine the impact of type 2 diabetes mellitus (T2DM) on visual functions, identify different modifiers as risk or protective factors, and find out how these factors affect patients' visual symptoms and visual functions as a whole. METHODS We performed an online survey among 1030 participants (400 patients, 630 non-patients). Demographic features and severity of disease were documented, while visual functions were evaluated using National Eye Institute Visual Functioning questionnaire-25 (NEI VFQ-25). Independent t-test, analysis of variance, linear and nonlinear regression models were used to assess all data. RESULTS Scores other than color vision among T2DM patients were significantly lower compared with non-T2DM participants. There was significant difference after stratification of age and education, but no significant difference between different genders was observed. Parameters including duration of T2DM, fasting plasma glucose (FPG) and glycosylated hemoglobin A1c (HbA1c) negatively impacted on the scores, with 20 years' of diabetic duration, 10 mmol/L of FPG, 7.5% of HbA1c being potential cut-off points. Poorer best corrected visual acuity (BCVA) and diagnosis of diabetic retinopathy were risk factors, while they simultaneously produced mediation effect, contributing 5%-78% of effect in the deterioration of visual functions caused by longer diabetic duration and higher blood glucose. CONCLUSION Significant visual impairments and faster deterioration in visual functions were seen in T2DM patients, with older age, lower educational level, longer diabetic duration, poorer blood glucose administration, limited BCVA, and the presence of diabetic retinopathy identified as risk factors. Average BCVA and diabetic retinopathy also yielded mediation effect as diabetic duration lengthened and blood glucose elevated.
Collapse
Affiliation(s)
- Sanbao Chai
- Department of Endocrinology and Metabolism, Peking University International Hospital, Beijing, 102206, People's Republic of China
| | - Yimeng Ge
- Department of Opthalmology, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Peking University Third Hospital Haidian District, 49 North Garden Road, Beijing, 100191, People's Republic of China
| | - Yu Wan
- Department of Opthalmology, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Peking University Third Hospital Haidian District, 49 North Garden Road, Beijing, 100191, People's Republic of China
| | - Huaqin Xia
- Department of Opthalmology, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Peking University Third Hospital Haidian District, 49 North Garden Road, Beijing, 100191, People's Republic of China
| | - Ruilan Dong
- Department of Opthalmology, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Peking University Third Hospital Haidian District, 49 North Garden Road, Beijing, 100191, People's Republic of China
| | - Xiaotong Ren
- Department of Opthalmology, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Peking University Third Hospital Haidian District, 49 North Garden Road, Beijing, 100191, People's Republic of China
| | - Hao Yuan
- Department of Opthalmology, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Peking University Third Hospital Haidian District, 49 North Garden Road, Beijing, 100191, People's Republic of China
| | - Qingyi Hou
- Department of Opthalmology, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Peking University Third Hospital Haidian District, 49 North Garden Road, Beijing, 100191, People's Republic of China
| | - Jiarui Yang
- Department of Opthalmology, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Peking University Third Hospital Haidian District, 49 North Garden Road, Beijing, 100191, People's Republic of China.
| | - Xuemin Li
- Department of Opthalmology, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Peking University Third Hospital Haidian District, 49 North Garden Road, Beijing, 100191, People's Republic of China.
| |
Collapse
|
12
|
Seid MA, Ambelu A, Diress M, Yeshaw Y, Akalu Y, Dagnew B. Visual impairment and its predictors among people living with type 2 diabetes mellitus at Dessie town hospitals, Northeast Ethiopia: institution-based cross-sectional study. BMC Ophthalmol 2022; 22:52. [PMID: 35114950 PMCID: PMC8815255 DOI: 10.1186/s12886-022-02292-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 01/27/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Visual impairment is a functional limitation of the eye(s) that results in reduced visual acuity, visual field loss, visual distortion, perceptual difficulties, or any combination of the above. Type 2 diabetes mellitus is one of the common causes of visual impairment. Since there is no study conducted in Ethiopia so far in this regard, the current study aimed to determine the prevalence and predictors of visual impairment among people living with diabetes at Dessie town Hospitals, Northeast Ethiopia. METHODS Institution based cross-sectional study was carried out from 15 February to 15 March 2020 using simple random sampling to recruit study participants among type 2 diabetes. Visual impairment was measured using visual acuity test. We used Epi Data 3.1 and SPSS version 22 for data entry and statistical analysis, respectively. Bi-variable binary logistic regression was performed to check independent association of each factor with visual impairment. After selecting candidate variables at p < 0.25, we computed multivariable binary logistic regression to identify statistically associated factors of visual impairment. The degree of association was determined using adjusted odds ratio with 95%CI. In the final model, statistical significance was declared at p < 0.05. RESULTS Three hundred and twenty-two people living with T2DM participated in this study with 97% response rate. The prevalence of visual impairment was 37.58% (95% CI: 32.3, 42.9). Age (AOR: 1.06, 95% CI: 1.02, 1.09, p < or = 0.001), poor regular exercise (AOR = 2.91, 95%CI: 1.47-5.76, p < or = 0.001), duration of DM above 5 years (AOR = 2.42, 95% CI: 1.25-4.73, p < or = 0.01), insulin treatment (AOR = 14.05, 95% CI: 2.72, 72.35, p < or = 0.01), and poor glycemic control (AOR = 2.17, 95% CI: 1.13-4.14, p < 0.05) were statistically associated with visual impairment. CONCLUSION The prevalence of visual impairment in Dessie town hospitals accounted for more than a third of patients living with T2DM. Visual impairment is associated with increased age, poor regular exercise, longer duration of DM, and insulin treatment. Thus, early detection of VI through screening and regular follow-up is recommended to reduce the risk of VI and vision loss.
Collapse
Affiliation(s)
- Mohammed Abdu Seid
- Unit of Human Physiology, Department of Biomedical Sciences, College of Health Sciences, Debre Tabor University, P. O. Box 272, Debre Tabor, Ethiopia.
| | - Adugnaw Ambelu
- Department of Human Physiology, College of Medicine and Health Sciences, University of Gondar, P. O. Box 196, Gondar, Ethiopia
| | - Mengistie Diress
- Department of Human Physiology, College of Medicine and Health Sciences, University of Gondar, P. O. Box 196, Gondar, Ethiopia
| | - Yigizie Yeshaw
- Department of Human Physiology, College of Medicine and Health Sciences, University of Gondar, P. O. Box 196, Gondar, Ethiopia
| | - Yonas Akalu
- Department of Human Physiology, College of Medicine and Health Sciences, University of Gondar, P. O. Box 196, Gondar, Ethiopia
| | - Baye Dagnew
- Department of Human Physiology, College of Medicine and Health Sciences, University of Gondar, P. O. Box 196, Gondar, Ethiopia
| |
Collapse
|
13
|
El-Kebbi IM, Bidikian NH, Hneiny L, Nasrallah MP. Epidemiology of type 2 diabetes in the Middle East and North Africa: Challenges and call for action. World J Diabetes 2021; 12:1401-1425. [PMID: 34630897 PMCID: PMC8472500 DOI: 10.4239/wjd.v12.i9.1401] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 06/21/2021] [Accepted: 08/02/2021] [Indexed: 02/06/2023] Open
Abstract
Type 2 diabetes continues to be a serious and highly prevalent public health problem worldwide. In 2019, the highest prevalence of diabetes in the world at 12.2%, with its associated morbidity and mortality, was found in the Middle East and North Africa region. In addition to a genetic predisposition in its population, evidence suggests that obesity, physical inactivity, urbanization, and poor nutritional habits have contributed to the high prevalence of diabetes and prediabetes in the region. These risk factors have also led to an earlier onset of type 2 diabetes among children and adolescents, negatively affecting the productive years of the youth and their quality of life. Furthermore, efforts to control the rising prevalence of diabetes and its complications have been challenged and complicated by the political instability and armed conflict in some countries of the region and the recent coronavirus disease 2019. Broad strategies, coupled with targeted interventions at the regional, national, and community levels are needed to address and curb the spread of this public health crisis.
Collapse
Affiliation(s)
- Imad M El-Kebbi
- Department of Internal Medicine, Division of Endocrinology, American University of Beirut Medical Center, Faculty of Medicine, Beirut 11072020, Lebanon
- Department of Internal Medicine, Sheikh Shakhbout Medical City, Abou Dhabi 11001, United Arab Emirates
| | - Nayda H Bidikian
- School of Medicine, American University of Beirut, Faculty of Medicine, Beirut 11072020, Lebanon
| | - Layal Hneiny
- University Libraries, Saab Medical Library, American University of Beirut, Beirut 11072020, Lebanon
| | - Mona Philippe Nasrallah
- Department of Internal Medicine, Division of Endocrinology, American University of Beirut Medical Center, Faculty of Medicine, Beirut 11072020, Lebanon
| |
Collapse
|
14
|
Gbessemehlan A, Helmer C, Delcourt C, Boumediene F, Ndamba-Bandzouzi B, Mbelesso P, Samba H, Kehoua G, Désormais I, Lacroix P, Aboyans V, Dartigues JF, Houinato D, Preux PM, Guerchet M. Cardiovascular Health and Near Visual Impairment Among Older Adults in the Republic of Congo: A Population-Based Study. J Gerontol A Biol Sci Med Sci 2021; 76:842-850. [PMID: 33438029 DOI: 10.1093/gerona/glaa304] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Visual impairment (VI) and determinants of poor cardiovascular health are very common in Sub-Saharan Africa. However, we do not know whether these determinants are associated with VI among older adults in this region. This study aimed at investigating the association between the determinants of poor cardiovascular health and near VI among older adults living in Congo. METHODS Participants were Congolese adults aged 65 or older included in Epidemiology of Dementia in Central Africa-Follow-up population-based cohort. Near VI was defined as visual acuity less than 20/40 measured at 30 cm. Associations between determinants of poor cardiovascular health collected at baseline and near visual acuity measured at first follow-up were investigated using multivariable logistic regression models. RESULTS Among the 549 participants included, 378 (68.8%; 95% confidence interval [CI]: 64.9%-72.7%]) had near VI. Of the determinants of poor cardiovascular health explored, we found that having high body mass index of at least 25 kg/m2 (odds ratio [OR] = 2.15; 95% CI: 1.25-3.68), diabetes (OR = 2.12; 95% CI: 1.06-4.25) and hypertension (OR = 1.65; 95% CI: 1.02-2.64) were independently associated with near VI. CONCLUSIONS Several determinants of poor cardiovascular health were associated with near VI in this population. This study suggests that promoting good cardiovascular health could represent a target for VI prevention among older adults.
Collapse
Affiliation(s)
- Antoine Gbessemehlan
- INSERM, Univ. Limoges, IRD, U1094 Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France.,Faculty of Health Sciences, Laboratory of Chronic and Neurologic Diseases Epidemiology, LEMACEN, University of Abomey-Calavi, Cotonou, Benin
| | - Catherine Helmer
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, France
| | - Cécile Delcourt
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, France
| | - Farid Boumediene
- INSERM, Univ. Limoges, IRD, U1094 Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France
| | | | - Pascal Mbelesso
- Department of Neurology, Amitié Hospital, Bangui, Central African Republic
| | - Harielle Samba
- INSERM, Univ. Limoges, IRD, U1094 Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France
| | - Gilles Kehoua
- INSERM, Univ. Limoges, IRD, U1094 Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France
| | - Ileana Désormais
- INSERM, Univ. Limoges, IRD, U1094 Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France.,Department of Thoracic and Cardiovascular Surgery and Angiology, Dupuytren University Hospital, Limoges, France
| | - Philippe Lacroix
- INSERM, Univ. Limoges, IRD, U1094 Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France.,Department of Thoracic and Cardiovascular Surgery and Angiology, Dupuytren University Hospital, Limoges, France
| | - Victor Aboyans
- INSERM, Univ. Limoges, IRD, U1094 Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France.,Department of Cardiology, Dupuytren University Hospital, Limoges, France
| | | | - Dismand Houinato
- INSERM, Univ. Limoges, IRD, U1094 Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France.,Faculty of Health Sciences, Laboratory of Chronic and Neurologic Diseases Epidemiology, LEMACEN, University of Abomey-Calavi, Cotonou, Benin
| | - Pierre-Marie Preux
- INSERM, Univ. Limoges, IRD, U1094 Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France
| | - Maëlenn Guerchet
- INSERM, Univ. Limoges, IRD, U1094 Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France
| |
Collapse
|
15
|
Giloyan A, Muradyan D, Khachadourian V. Visual impairment and associated risk factors in patients with diabetes mellitus in Tavush and Armavir provinces of Armenia. Int Ophthalmol 2021; 42:47-56. [PMID: 34379291 DOI: 10.1007/s10792-021-01998-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 07/30/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Visual impairment (VI) and blindness remain serious public health problems among patients with diabetes. This study assessed the prevalence of VI and its associated risk factors in individuals with diabetes mellitus (DM) in Armenia. METHODS This cross-sectional study recruited 1287 people with DM. All participants underwent comprehensive ophthalmic examination and responded to a structured questionnaire on sociodemographic and health characteristics, health-seeking behavior, and ocular health. The presence of eye diseases and VI was defined based on the International Classification of Diseases-11. Descriptive statistics and logistic regression were used to address the study objectives. RESULTS The mean age of participants was 61.5 (SD = 9.6) ranging from 19.4 to 99.8 years. The mean duration of diabetes was 7.4 years. The majority of participants (70.5%) were women. The prevalence of VI and blindness was 12.1% and 0.9%, respectively. Overall, 22.4% of participants had diabetic retinopathy. In the adjusted analysis, advanced age (OR = 1.08; 95%CI: 1.06-1.11), higher education (OR = 0.37; 95%CI: 0.19-0.74), diabetes duration (OR = 1.05; 95%CI: 1.02-1.08), the presence of diabetic retinopathy (OR = 3.61; 95%CI: 2.38-5.46), age-related macular degeneration (OR = 1.88; 95%CI: 1.15-3.05), cataract (OR = 2.45; 95%CI: 1.66-3.63), and glaucoma (OR = 2.32; 95%CI: 1.25-4.30) were associated with VI. CONCLUSION The findings highlight the importance and need for regular eye screening and diabetes prevention programs in the country. Continuous educational programs on diabetes self-management among patients with DM can reduce complications of diabetes including vision loss due to diabetes.
Collapse
Affiliation(s)
- Aida Giloyan
- Turpanjian School of Public Health, Garo Meghrigian Institute for Preventive Ophthalmology, American University of Armenia, 40 Marshal Baghramian Ave., 0019, Yerevan, Armenia.
| | - Diana Muradyan
- Turpanjian School of Public Health, American University of Armenia, 40 Marshal Baghramian Ave, 0019, Yerevan, Armenia
| | - Vahe Khachadourian
- Turpanjian School of Public Health, American University of Armenia, 40 Marshal Baghramian Ave, 0019, Yerevan, Armenia
| |
Collapse
|
16
|
Sun Y, Jin G, Yang M, Fu J, Chen X, Lou B. Prevalence, Risk Factors, and Causes of Visual Impairment in an Elderly Chinese Uygur Population in Southern Xinjiang. J Ophthalmol 2021; 2021:8843032. [PMID: 33880187 DOI: 10.1155/2021/8843032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Revised: 01/14/2021] [Accepted: 03/26/2021] [Indexed: 11/21/2022] Open
Abstract
Purpose To investigate the prevalence, risk factors, and major causes of visual impairment (VI) in an elderly Chinese Uygur population in southern Xinjiang. Methods This was a population-based cross-sectional study. Participants aged 50 years and older from Haohan Country, Xinjiang Uygur Autonomous Region, were enrolled from August 2018 to December 2018 using cluster sampling. Participants underwent examinations including presenting visual acuity (PVA), pinhole vision, slit-lamp, intraocular pressure, and direct ophthalmoscopy. Participants' education and demographic information was collected by a questionnaire. The prevalence, risk factors, and major causes of vision loss were evaluated. Results A total of 1465 participants (85.4% response rate) were enrolled. The mean age of the subjects was 59.1 ± 9.7 years. The prevalence of mild VI, moderate VI, severe VI, and blindness in the better eye was 13.3%, 12.8%, 2.9%, and 3.4%, respectively. The prevalence of low vision and blindness in this study was higher than that in Altay & Tacheng and Changji in northern Xinjiang, lower than that in Luxi, and similar to that in Tibet. The multiple logistic regression analysis showed that age, education level, and body mass index (BMI) were significantly associated with low vision and blindness (P ≤ 0.001, <0.05, 0.002, respectively). The major causes of low vision were cataract (42.6%), refractive error (19.6%), and glaucoma (12.6%), whereas the primary causes of blindness were cataract (34%), glaucoma (34%), and retinitis pigmentosa (10%). Conclusions VI is an important public health issue among elderly Uygur individuals in the area, especially for those with low education levels. Cataract is the leading cause of low vision and blindness.
Collapse
|
17
|
Sada KB, Sabir AA, Sakajiki AM, Umar MT, Abdullahi U, Sikiru YA. Clinical profile of patients with diabetes mellitus in gusau, Northwestern, Nigeria. Ann Afr Med 2021; 20:78-83. [PMID: 34213472 PMCID: PMC8378458 DOI: 10.4103/aam.aam_16_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Revised: 10/11/2020] [Accepted: 02/04/2021] [Indexed: 11/25/2022] Open
Abstract
Background There are variable reports of glycemic control and complications among patients living with diabetes mellitus (DM). Aim The aim of this study was to determine the glycemic control and complications among patients with DM seen at the medical outpatient department of a tertiary health institution in Northwestern Nigeria. Methodology This was a descriptive cross-sectional study of 236 patients attending DM Clinic at Federal Medical Centre Gusau. A questionnaire was administered that contains sociodemographic characteristics of the patients, duration of DM, adherence to management, and complications. Anthropometry, blood pressures, and fasting plasma glucose (FPG) were recorded. Data were analyzed using SPSS version 20.0. Results Eighty-six (36%) males and 150 (64%) females patients with DM were evaluated. Their mean (standard deviation [SD]) age was 53.5 ± 12.3 years with mean (SD) duration of DM of 7.9 ± 6.2 years. The mean FPG was 8.85 ± 3.8 mmol/L (males 8.21 ± 3.6, females 9.49 ± 3.8). Forty-seven (20%), 75 (32%), 113 (48%) of the patients had good, fair, and poor glycemic control, respectively. The major complications observed were peripheral neuropathy (61%) and visual impairment (51%). Glycemic control was significantly better among males and those with good adherence to medications. There was a positive association between the longer duration of DM with complications. Conclusion Only 20% of our patients achieved good glycemic control and many have complications. Majority of the patients adhered more with medications as compared to dietary management and exercise. There is a need for clinicians to educate patients more on the need for lifestyle modifications.
Collapse
Affiliation(s)
| | - A. A. Sabir
- Department of Medicine, Usmanu Danfodiyo University, Sokoto, Nigeria
| | - A. M. Sakajiki
- Department of Medicine, Usmanu Danfodiyo University, Sokoto, Nigeria
| | - M. T. Umar
- Department of Medicine, Usmanu Danfodiyo University, Sokoto, Nigeria
| | - U. Abdullahi
- Department of Medicine, Federal Medical Centre, Gusau, Nigeria
| | - Y. A. Sikiru
- Department of Medicine, Federal Medical Centre, Gusau, Nigeria
| |
Collapse
|
18
|
AlQahtani AS, Hazzazi MA, Waheeb SA, Semidey VA, Semidey VA, Elgendy HK, Alkhars WI, Abouammoh MA, Al-Dhibi H. Saudi Arabia Guidelines for diabetic macular edema: A consensus of the Saudi Retina Group. Saudi Med J 2021; 42:131-145. [PMID: 33563731 PMCID: PMC7989293 DOI: 10.15537/smj.2021.2.25623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 12/08/2020] [Indexed: 11/25/2022] Open
Abstract
Diabetes mellitus (DM) and its complications are major public health burdens in Saudi Arabia. The prevalence of diabetic retinopathy (DR) is 19.7% and the prevalence of diabetic macular edema (DME) is 5.7% in Saudi Arabia. Diabetic macular edema is a vision-threatening complication of DR and a major cause of vision loss worldwide. Ocular treatments include retinal laser photocoagulation, anti-vascular endothelial growth factor (anti-VEGF) agents, intravitreal corticosteroids, and vitreoretinal surgery when necessary. The present consensus was developed as a part of the Saudi Retina Group's efforts to generate Saudi guidelines and consensus for the management of DME, including recommendations for its diagnosis, treatment, and best practice. The experts' panel stipulates that the treatment algorithm should be categorized according to the presence of central macula involvement. In patients with no central macular involvement, laser photocoagulation is recommended as the first-line option. Patients with central macular involvement and no recent history of cardiovascular (CVS) or cerebrovascular disorders can be offered anti-VEGF agents as the first-line option. In the case of non-responders (defined as an improvement of <20% in optical coherence tomography or a gain of fewer than 5 letters in vision), switching to another anti-VEGF agent or steroids should be considered after 3 injections. Within the class of steroids, dexamethasone implants are recommended as the first choice. In patients with a recent history of CVS events, the use of anti-VEGF agents is not recommended, regardless of their lens status. The experts' panel recommends that a future study be conducted to provide a cut-off point for early switching to steroid implants in pseudo-phakic eyes.
Collapse
Affiliation(s)
- Abdullah S. AlQahtani
- From the Department of Surgery (AlQahtani), Division of Ophthalmology, National Guard Hospital, and from King Saud bin Abdulaziz University for Health Sciences; from the Department of Ophthalmology (Waheeb), King Fisal Specialist Hospital and Research Center; from the Department of Ophthalmology (Elgendy), Retina Unit, Magrabi Eye and Ear Hospital, Jeddah; from the Department of Surgery (Hazzazi), Division of Ophthalmology, Riyadh National Guard Hospital, and from King Saud bin Abdulaziz University for Health Sciences; from the Department of Vitreoretinal (Semidey, Al-Dhibi), King Khalid Eye Specialist Hospital; from the Department of Ophthalmology (Abouammoh), College of Medicine, King Saud University, Riyadh; and from the Department of Retina and Uveitis (Alkhars), Dhahran Eye Specialist Hospital, Dhahran, Kingdom of Saudi Arabia.
| | - Mohammad A. Hazzazi
- From the Department of Surgery (AlQahtani), Division of Ophthalmology, National Guard Hospital, and from King Saud bin Abdulaziz University for Health Sciences; from the Department of Ophthalmology (Waheeb), King Fisal Specialist Hospital and Research Center; from the Department of Ophthalmology (Elgendy), Retina Unit, Magrabi Eye and Ear Hospital, Jeddah; from the Department of Surgery (Hazzazi), Division of Ophthalmology, Riyadh National Guard Hospital, and from King Saud bin Abdulaziz University for Health Sciences; from the Department of Vitreoretinal (Semidey, Al-Dhibi), King Khalid Eye Specialist Hospital; from the Department of Ophthalmology (Abouammoh), College of Medicine, King Saud University, Riyadh; and from the Department of Retina and Uveitis (Alkhars), Dhahran Eye Specialist Hospital, Dhahran, Kingdom of Saudi Arabia.
| | - Saad A. Waheeb
- From the Department of Surgery (AlQahtani), Division of Ophthalmology, National Guard Hospital, and from King Saud bin Abdulaziz University for Health Sciences; from the Department of Ophthalmology (Waheeb), King Fisal Specialist Hospital and Research Center; from the Department of Ophthalmology (Elgendy), Retina Unit, Magrabi Eye and Ear Hospital, Jeddah; from the Department of Surgery (Hazzazi), Division of Ophthalmology, Riyadh National Guard Hospital, and from King Saud bin Abdulaziz University for Health Sciences; from the Department of Vitreoretinal (Semidey, Al-Dhibi), King Khalid Eye Specialist Hospital; from the Department of Ophthalmology (Abouammoh), College of Medicine, King Saud University, Riyadh; and from the Department of Retina and Uveitis (Alkhars), Dhahran Eye Specialist Hospital, Dhahran, Kingdom of Saudi Arabia.
| | - Valmore A. Semidey
- From the Department of Surgery (AlQahtani), Division of Ophthalmology, National Guard Hospital, and from King Saud bin Abdulaziz University for Health Sciences; from the Department of Ophthalmology (Waheeb), King Fisal Specialist Hospital and Research Center; from the Department of Ophthalmology (Elgendy), Retina Unit, Magrabi Eye and Ear Hospital, Jeddah; from the Department of Surgery (Hazzazi), Division of Ophthalmology, Riyadh National Guard Hospital, and from King Saud bin Abdulaziz University for Health Sciences; from the Department of Vitreoretinal (Semidey, Al-Dhibi), King Khalid Eye Specialist Hospital; from the Department of Ophthalmology (Abouammoh), College of Medicine, King Saud University, Riyadh; and from the Department of Retina and Uveitis (Alkhars), Dhahran Eye Specialist Hospital, Dhahran, Kingdom of Saudi Arabia.
| | - Valmore A. Semidey
- From the Department of Surgery (AlQahtani), Division of Ophthalmology, National Guard Hospital, and from King Saud bin Abdulaziz University for Health Sciences; from the Department of Ophthalmology (Waheeb), King Fisal Specialist Hospital and Research Center; from the Department of Ophthalmology (Elgendy), Retina Unit, Magrabi Eye and Ear Hospital, Jeddah; from the Department of Surgery (Hazzazi), Division of Ophthalmology, Riyadh National Guard Hospital, and from King Saud bin Abdulaziz University for Health Sciences; from the Department of Vitreoretinal (Semidey, Al-Dhibi), King Khalid Eye Specialist Hospital; from the Department of Ophthalmology (Abouammoh), College of Medicine, King Saud University, Riyadh; and from the Department of Retina and Uveitis (Alkhars), Dhahran Eye Specialist Hospital, Dhahran, Kingdom of Saudi Arabia.
| | - Hussein K. Elgendy
- From the Department of Surgery (AlQahtani), Division of Ophthalmology, National Guard Hospital, and from King Saud bin Abdulaziz University for Health Sciences; from the Department of Ophthalmology (Waheeb), King Fisal Specialist Hospital and Research Center; from the Department of Ophthalmology (Elgendy), Retina Unit, Magrabi Eye and Ear Hospital, Jeddah; from the Department of Surgery (Hazzazi), Division of Ophthalmology, Riyadh National Guard Hospital, and from King Saud bin Abdulaziz University for Health Sciences; from the Department of Vitreoretinal (Semidey, Al-Dhibi), King Khalid Eye Specialist Hospital; from the Department of Ophthalmology (Abouammoh), College of Medicine, King Saud University, Riyadh; and from the Department of Retina and Uveitis (Alkhars), Dhahran Eye Specialist Hospital, Dhahran, Kingdom of Saudi Arabia.
| | - Wajeeha I. Alkhars
- From the Department of Surgery (AlQahtani), Division of Ophthalmology, National Guard Hospital, and from King Saud bin Abdulaziz University for Health Sciences; from the Department of Ophthalmology (Waheeb), King Fisal Specialist Hospital and Research Center; from the Department of Ophthalmology (Elgendy), Retina Unit, Magrabi Eye and Ear Hospital, Jeddah; from the Department of Surgery (Hazzazi), Division of Ophthalmology, Riyadh National Guard Hospital, and from King Saud bin Abdulaziz University for Health Sciences; from the Department of Vitreoretinal (Semidey, Al-Dhibi), King Khalid Eye Specialist Hospital; from the Department of Ophthalmology (Abouammoh), College of Medicine, King Saud University, Riyadh; and from the Department of Retina and Uveitis (Alkhars), Dhahran Eye Specialist Hospital, Dhahran, Kingdom of Saudi Arabia.
| | - Marwan A. Abouammoh
- From the Department of Surgery (AlQahtani), Division of Ophthalmology, National Guard Hospital, and from King Saud bin Abdulaziz University for Health Sciences; from the Department of Ophthalmology (Waheeb), King Fisal Specialist Hospital and Research Center; from the Department of Ophthalmology (Elgendy), Retina Unit, Magrabi Eye and Ear Hospital, Jeddah; from the Department of Surgery (Hazzazi), Division of Ophthalmology, Riyadh National Guard Hospital, and from King Saud bin Abdulaziz University for Health Sciences; from the Department of Vitreoretinal (Semidey, Al-Dhibi), King Khalid Eye Specialist Hospital; from the Department of Ophthalmology (Abouammoh), College of Medicine, King Saud University, Riyadh; and from the Department of Retina and Uveitis (Alkhars), Dhahran Eye Specialist Hospital, Dhahran, Kingdom of Saudi Arabia.
| | - Hassan Al-Dhibi
- From the Department of Surgery (AlQahtani), Division of Ophthalmology, National Guard Hospital, and from King Saud bin Abdulaziz University for Health Sciences; from the Department of Ophthalmology (Waheeb), King Fisal Specialist Hospital and Research Center; from the Department of Ophthalmology (Elgendy), Retina Unit, Magrabi Eye and Ear Hospital, Jeddah; from the Department of Surgery (Hazzazi), Division of Ophthalmology, Riyadh National Guard Hospital, and from King Saud bin Abdulaziz University for Health Sciences; from the Department of Vitreoretinal (Semidey, Al-Dhibi), King Khalid Eye Specialist Hospital; from the Department of Ophthalmology (Abouammoh), College of Medicine, King Saud University, Riyadh; and from the Department of Retina and Uveitis (Alkhars), Dhahran Eye Specialist Hospital, Dhahran, Kingdom of Saudi Arabia.
| |
Collapse
|
19
|
Aitchison RT, Kennedy GJ, Shu X, Mansfield DC, Shahani U. Sub-clinical thickening of the fovea in diabetes and its relationship to glycaemic control: a study using swept-source optical coherence tomography. Graefes Arch Clin Exp Ophthalmol 2020; 259:633-641. [PMID: 32897439 PMCID: PMC7904733 DOI: 10.1007/s00417-020-04914-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 07/23/2020] [Accepted: 08/25/2020] [Indexed: 01/14/2023] Open
Abstract
Background Accumulation of multiple pockets of fluid at the fovea, as a complication of poor blood glucose control in diabetes, causes impairment of central vision. A new ability to demonstrate a pre-clinical phase of this maculopathy could be valuable, enabling diabetic individuals to be alerted to the need to improve their glycaemic control. This study aimed to use swept-source optical coherence tomography (SS-OCT) to measure foveal thickness and macular volume in diabetic individuals without cystoid macular oedema, and in non-diabetic individuals, and relate these measures to participants’ glycaemic control. Methods Centre point thickness (CPT) and total macular volume (TMV) were measured using SS-OCT (DRI OCT Triton™, Topcon, Tokyo, Japan). Participants’ glycosylated haemoglobin (HbA1c) level was also assessed (A1cNow®+ System, PTS Diagnostics, Indianapolis, IN, USA). The diabetic (n = 27) and non-diabetic (n = 27) groups were matched for age (p = 0.100) and sex (p = 0.414), and HbA1c level differed between diabetic and non-diabetic groups (p < 0.0005). The diabetic group comprised type 1 (n = 7) and type 2 (n = 20) diabetic individuals who were matched for duration of diabetes (p = 0.617) and whose glycaemic control was similar (p = 0.814). Results Diabetic individuals had significantly higher CPT (t(37) = 3.859, p < 0.0005) than non-diabetic individuals. In the diabetic group, multiple linear regression analysis revealed a conspicuous relationship between CPT and HbA1c level (β = 0.501, t(21) = 3.139, p = 0.005): there was a 19-μm increase in CPT for each 1% increase in HbA1c level. This relationship was not present in the non-diabetic group (β = − 0.068, t(23) = − 0.373, p = 0.712). Conclusions SS-OCT is the only way to measure macular thickness in vivo. Diabetic individuals en bloc had higher CPT compared with non-diabetic individuals. Moreover, in the diabetic group, HbA1c level significantly predicted CPT. Our results suggest that, in diabetes, sub-clinical thickening may occur at the fovea before cystoid macular oedema becomes clinically evident. This could provide diabetic individuals with an early warning of disease progression and motivate them to improve control of their diabetes, with a view to avoiding the need of intra-vitreal injections with their attendant risks.![]()
Collapse
Affiliation(s)
- Ross T Aitchison
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK.
| | - Graeme J Kennedy
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Xinhua Shu
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - David C Mansfield
- Department of Ophthalmology, Inverclyde Royal Hospital, Greenock, UK
| | - Uma Shahani
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK.
| |
Collapse
|
20
|
Nkanga D, Adenuga O, Okonkwo O, Ovienria W, Ibanga A, Agweye C, Oyekunle I, Akanbi T. Profile, Visual Presentation and Burden of Retinal Diseases Seen in Ophthalmic Clinics in Sub-Saharan Africa. Clin Ophthalmol 2020; 14:679-687. [PMID: 32189962 PMCID: PMC7067142 DOI: 10.2147/opth.s226494] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Accepted: 01/21/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose To determine the burden of retinal diseases and the degree of visual impairment associated with each disease, amongst Nigerians. Patients and Methods This was a hospital-based multicenter, prospective, cross-sectional, non-comparative study conducted from January to December 2018. Data was obtained from consecutive patients with a retinal diagnosis presenting at the general ophthalmic and specialty retina clinics in four hospitals (three public, and one private teaching eye department) in Nigeria. Biodata, visual acuity and refraction, intraocular pressure, findings on dilated retinal examination, diagnosis and systemic diseases were noted. Degree of monocular and bilateral visual loss associated with each diagnosed retinal disease was summarized and p value was calculated using chi-square test. P < 0.05 was considered significant. Results Eight hundred seventy-six of 8614 patients had a retinal diagnosis; establishing a hospital-based retinal disease prevalence of 9.8%. Male:female ratio was 1.1:1. The mean age of study patients was 49.97 (standard deviation 17.64 years). Mean symptom duration was 21.63 months (standard deviation 41.94). The mean intraocular pressure was 13.87 mmHg. Forty-three different retinal diseases were diagnosed. The most common was retinal complications of diabetes, i.e., diabetic retinopathy (DR) alone, diabetic macular edema (DME) alone and a combination of DR and DME, which accounted for 13.7%, 5.6% and 9.3%, respectively (contributed 28.6% of the entire diagnosis). This was followed by retinal detachment (RD), in 219 eyes (15.4%), dry age-related macular degeneration (AMD) in 124 eyes (8.7%). Nearly half of the eyes were blind or severely visually impaired. Blindness occurred in 34.1% of eyes; severe visual impairment in 8.2% of eyes and 29.7% had normal vision. There were 469 patients who had systemic diseases. The common systemic diseases were hypertension in 169 patients (19.3% of the total number of patients), hypertension and diabetes in 156 patients (18%), and diabetes alone in 98 patients (11.1%). Sickle cell disease was present in 1.5%. Conclusion There is need to invest in infrastructure, local training and development of systems for early detection and treatment of several retinal diseases in sub-Saharan Africa; DR and DME having the largest burden. Collaborative physician care and management of hypertension and diabetes could significantly reduce the burden of DR and DME.
Collapse
Affiliation(s)
- Dennis Nkanga
- University of Calabar Teaching Hospital, Calabar, Nigeria
| | | | | | | | - Affiong Ibanga
- University of Calabar Teaching Hospital, Calabar, Nigeria
| | - Chineze Agweye
- University of Calabar Teaching Hospital, Calabar, Nigeria
| | | | | | | |
Collapse
|
21
|
Pidro A, Ahmedbegovic-Pjano M, Grisevic S, Sofic-Drino V, Gabric K, Biscevic A. Epidemiology of Diabetic Retinopathy at Eye Clinic Svjetlost Sarajevo: Two Years Retrospective Single Center Study. Mater Sociomed 2020; 31:290-293. [PMID: 32082096 PMCID: PMC7007630 DOI: 10.5455/msm.2019.31.290-293] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Introduction: Diabetic retinopathy (DR) is an important cause of blindness, and occurs as a result of long-term accumulated damage to the small blood vessels in the retina. 2.6% of global blindness can be attributed to diabetes. Disease severity was most often classified by the Early Treatment Diabetic Retinopathy Study (ETDRS) classification for DR severity. Patients are usually categorized based on the severity of DR as having mild nonproliferative diabetic retinopathy (NPDR), moderate NPDR, severe NPDR, or proliferative diabetic retinopathy (PDR). Aim: To evaluate DR status among patients at Eye Clinic Svjetlost Sarajevo , both, type 1 and type 2 DM patients who presented in our clinic at 2 years period – from June 2016 to June 2018. This is single center study. Methods: Retrospective analysis of 753 diabetic patients that came for the first check up in our institution during those two years, 363 patients were male and 390 were female. Patients were divided in 3 groups (based on DR changes): a) No changes, b) Nonproliferative DR (with and without Diabetic macular edema–DME), c) Prolipherative DR (with and without DME + Advanced PDR). Results: There were 35% of patients with no ocular changes, 41.2% had NPDR and 24% had PDR. Prevalence of DR in our study was 65.32%. Distribution of NPDR was 66.27%, and PDR was 33.73%. DME was present in 33.70% cases. In NPDR, DME was presented in 51% of the cases, while in PDR was presented in 49% of the cases. In state of advanced PDR, PDR was presented in 30.52% cases, tractional detachment and haemophtalmus in 50.20% of cases and neovascular glaucoma in 19.28%. Sixty-three patients ended up with vitroretinal surgery (8.4%) while in other studies that number is up to 3%. Out of that number 9 patients were patient with virgin eyes (14.28%). Neovascular glaucoma occurred in 19.28% of diabetics with proliferative retinopathy and 4.60% in all of diabetics. Conclusion: Diabetic retinopathy status of patients presenting at Eye clinic Svjetlost Sarajevo, Bosnia and Herzegovina is quite poor. There is a big need for early DR screening measures, good prevention and management of DR risk factors. Adequate and ON TIME management of DM and its vision threatening complications is of major importance.
Collapse
Affiliation(s)
- Ajla Pidro
- Eye Clinic Svjetlost Sarajevo, Sarajevo, Bosnia and Herzegovina
| | | | - Senad Grisevic
- Eye Clinic Svjetlost Sarajevo, Sarajevo, Bosnia and Herzegovina
| | | | | | - Alma Biscevic
- Eye Clinic Svjetlost Sarajevo, Sarajevo, Bosnia and Herzegovina.,University Eye Clinic Svjetlost Zagreb, Zagreb, Croatia
| |
Collapse
|
22
|
Harahap J, Rania R. Cataracts Risk Factors and Comparison of Blood Glucose Levels in Diabetic and Non-Diabetic Patients towards the Occurrence of Cataracts. Open Access Maced J Med Sci 2019; 7:3359-3362. [PMID: 32002050 PMCID: PMC6980819 DOI: 10.3889/oamjms.2019.422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 09/15/2019] [Accepted: 09/16/2019] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND: Cataracts are a multifactorial systemic disease that causes opacity of the optical lens. One aetiology of cataracts is chronic hyperglycemia, usually caused by uncontrolled diabetes mellitus. AIM: The objective of this study is to identify risk factors of cataracts and to analyse if there is a significant difference in blood glucose values between diabetic patients with cataracts and non-diabetic patients with cataracts. METHODS: This was an analytical case-control study with a sample size of 140 patients that were obtained via consecutive sampling of medical records. RESULTS: This study found that age, high body mass index and hypertension were the dominant risk factors of cataracts. The mean value of blood glucose levels in diabetic patients with cataracts is 195.58 ± 63.9 and 109.7 ± 26.4 in non-diabetic patients with cataracts. There was a significant difference between the blood glucose values of diabetic patients with cataracts and non-diabetic patients with cataracts (p < 0.001). The dominant risk factors of cataracts were old age, high body mass index and hypertension. The majority of hyperglycemic patients belong in the group of diabetic patients with cataracts. CONCLUSION: Chronic hyperglycemia can increase a patient’s risk of cataracts.
Collapse
Affiliation(s)
- Juliandi Harahap
- Department of Community Medicine, Faculty of Medicine, Universitas Sumatera Utara, Jl. Dr.Mansyur, no. 5 Kampus USU, Medan Baru, Kota Medan, Sumatera Utara 20155, Indonesia
| | - Rashvini Rania
- Department of Community Medicine, Faculty of Medicine, Universitas Sumatera Utara, Jl. Dr.Mansyur, no. 5 Kampus USU, Medan Baru, Kota Medan, Sumatera Utara 20155, Indonesia
| |
Collapse
|
23
|
Diallo JW, Dolo M, Sanou J, Yoda A, Ahnoux-Zabsonré A, Méda N. [What do we know about diabetic retinopathy at the Sourô Sanou university medical center in Bobo-Dioulasso (CHUSS)?]. J Fr Ophtalmol 2019; 42:361-367. [PMID: 30910329 DOI: 10.1016/j.jfo.2018.11.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 10/29/2018] [Accepted: 11/09/2018] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Ocular damage is one of the numerous complications of diabetes. Proliferative diabetic retinopathy can result in blindness. The purpose of our work was to study the aspects of diabetic retinopathy on fundus examination in diabetic patients in Bobo-Dioulasso in a hospital environment. METHODS This is a descriptive, cross-sectional, prospective study from March 1st to August 31st 2014 of diabetic patients in the Sourô Sanou university hospital. We used the Francophone Diabetes Society's classification. RESULTS We included 246 patients (487 eyes). The frequency of diabetic retinopathy (DR) was 47.1%, and the frequency of diabetic maculopathy 8.9%. Proliferative DR and severe Non-Proliferative DR represented 3.3% of eyes, and blindness occurred in 3%. Among diabetics with DR, the mean age was 55.75 years (standard deviation 11.04 years); the median duration of diabetes was 36 months, and 99.1% of the diabetic patients were categorized as type 2. There was a statistically significant association between diabetic retinopathy and duration of diabetes progression, history of neuropathy, presence of proteinuria on 24hour urines, hypercreatininemia, and also between triglyceride levels and diabetic maculopathy. CONCLUSION Diabetic retinopathy affects almost half of diabetic patients at the Sourô Sanou university hospital. An earlier, multidisciplinary management approach might prevent this.
Collapse
Affiliation(s)
- J W Diallo
- Service d'ophtalmologie, centre hospitalier universitaire Sourô Sanou 01 BP616, Bobo-Dioulasso, Burkina Faso.
| | - M Dolo
- Service d'ophtalmologie, centre hospitalier universitaire Sourô Sanou 01 BP616, Bobo-Dioulasso, Burkina Faso
| | - J Sanou
- Service d'ophtalmologie, centre hospitalier universitaire Yalgago Ouédraogo, 03 BP7022, Ouagadougou, Burkina Faso
| | - A Yoda
- Service d'ophtalmologie, centre hospitalier universitaire Sourô Sanou 01 BP616, Bobo-Dioulasso, Burkina Faso
| | - A Ahnoux-Zabsonré
- Service d'ophtalmologie, centre hospitalier universitaire Yalgago Ouédraogo, 03 BP7022, Ouagadougou, Burkina Faso
| | - N Méda
- Service d'ophtalmologie, centre hospitalier universitaire Yalgago Ouédraogo, 03 BP7022, Ouagadougou, Burkina Faso
| |
Collapse
|
24
|
Lee KS, Park KW. Social Determinants of Association among Diabetes Mellitus, Visual Impairment and Hearing Loss in a Middle-Aged or Old Population: Artificial-Neural-Network Analysis of the Korean Longitudinal Study of Aging (2014⁻2016). Geriatrics (Basel) 2019; 4:geriatrics4010030. [PMID: 30934564 PMCID: PMC6473411 DOI: 10.3390/geriatrics4010030] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 03/21/2019] [Accepted: 03/22/2019] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND This study introduces a new framework based on an artificial neural network (ANN) for testing whether social determinants are major determinants of association among diabetes mellitus, visual impairment and hearing loss in a middle-aged or old population. METHODS The data came from the Korean Longitudinal Study of Aging (2014⁻2016), with 6120 participants aged 45 years or more. The association was divided into eight categories: one category for having no disease, three categories for having one, three categories for having two and one category for having three. Variable importance, the effect of a variable on model performance, was used to evaluate the hypothesis based on whether family support, socioeconomic status and social activity in Y2014 are among the top 10 determinants of the association in the year 2016 (Y2016). RESULTS Based on variable importance from the ANN, brothers/sisters cohabiting (0.0167), voluntary activity (0.0148), income (0.0125), family activity (0.0125), parents alive (0.0121), leisure activity (0.0095) and meeting with friends (0.0092) in Y2014 are the top-10 determinants of comorbidity in Y2016. CONCLUSION The findings of this study support the hypothesis, highlighting the importance of social determinants for the effective management of the comorbidities of the three diseases.
Collapse
Affiliation(s)
- Kwang-Sig Lee
- Center for Artificial Intelligence, Korea University College of Medicine, Seoul 02841, Korea.
| | - Kun Woo Park
- Department of Neurology, Korea University College of Medicine, Seoul 02841, Korea.
| |
Collapse
|
25
|
Kahloun R, Khairallah M, Resnikoff S, Cicinelli MV, Flaxman SR, Das A, Jonas JB, Keeffe JE, Kempen JH, Leasher J, Limburg H, Naidoo K, Pesudovs K, Silvester AJ, Tahhan N, Taylor HR, Wong TY, Bourne RRA. Prevalence and causes of vision loss in North Africa and Middle East in 2015: magnitude, temporal trends and projections. Br J Ophthalmol 2018; 103:863-870. [PMID: 30209082 DOI: 10.1136/bjophthalmol-2018-312068] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2018] [Revised: 06/19/2018] [Accepted: 06/24/2018] [Indexed: 11/03/2022]
Abstract
BACKGROUND To assess the prevalence and causes of vision impairment in North Africa and the Middle East (NAME) from 1990 to 2015 and to forecast projections for 2020. METHODS Based on a systematic review of medical literature, the prevalence of blindness (presenting visual acuity (PVA) <3/60 in the better eye), moderate and severe vision impairment (MSVI; PVA <6/18 but ≥3/60) and mild vision impairment (PVA <6/12 but ≥6/18) was estimated for 2015 and 2020. RESULTS The age-standardised prevalence of blindness and MSVI for all ages and genders decreased from 1990 to 2015, from 1.72 (0.53-3.13) to 0.95% (0.32%-1.71%), and from 6.66 (3.09-10.69) to 4.62% (2.21%-7.33%), respectively, with slightly higher figures for women than men. Cataract was the most common cause of blindness in 1990 and 2015, followed by uncorrected refractive error. Uncorrected refractive error was the leading cause of MSVI in the NAME region in 1990 and 2015, followed by cataract. A reduction in the proportions of blindness and MSVI due to cataract, corneal opacity and trachoma is predicted by 2020. Conversely, an increase in the proportion of blindness attributable to uncorrected refractive error, glaucoma, age-related macular degeneration and diabetic retinopathy is expected. CONCLUSIONS In 2015 cataract and uncorrected refractive error were the major causes of vision loss in the NAME region. Proportions of vision impairment from cataract, corneal opacity and trachoma are expected to decrease by 2020, and those from uncorrected refractive error, glaucoma, diabetic retinopathy and age-related macular degeneration are predicted to increase by 2020.
Collapse
Affiliation(s)
- Rim Kahloun
- Les Ophtalmologistes Associés de Monastir, Monastir, Tunisia
| | - Moncef Khairallah
- Department of Ophthalmology, Fattouma Bourguiba University Hospital, Faculty of Medicine, University of Monastir, Monastir, Tunisia
| | - Serge Resnikoff
- Brien Holden Vision Institute, Sydney, New South Wales, Australia.,School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia
| | | | - Seth R Flaxman
- Department of Mathematics and Data Science Institute, Imperial College London, London, UK
| | - Aditi Das
- Health Education Yorkshire and the Humber, London, UK
| | - Jost B Jonas
- Department of Ophthalmology, Universitätsmedizin, Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | | | - John H Kempen
- Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA.,MyungSung Christian Medical Center and Medical School, Discovery Eye Center, Addis Ababa, Ethiopia
| | - Janet Leasher
- Nova Southeastern University, Fort Lauderdale, Florida, USA
| | - Hans Limburg
- Health Information Services, Grootebroek, The Netherlands
| | - Kovin Naidoo
- Brien Holden Vision Institute, Sydney, New South Wales, Australia.,African Vision Research Institute, University of Kwazulu-Natal, Durban, South Africa
| | | | | | - Nina Tahhan
- Brien Holden Vision Institute, Sydney, New South Wales, Australia.,School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia
| | - Hugh R Taylor
- Melbourne School of Population Health, University of Melbourne, Parkville, Melbourne, Australia
| | - Tien Yin Wong
- Singapore Eye Research Institute, Duke-NUS Graduate Medical School, National University of Singapore, Singapore, Singapore
| | - Rupert R A Bourne
- Vision and Eye Research Unit, School of Medicine, Anglia Ruskin University, Cambridge, UK
| | | |
Collapse
|
26
|
Acan D, Calan M, Er D, Arkan T, Kocak N, Bayraktar F, Kaynak S. The prevalence and systemic risk factors of diabetic macular edema: a cross-sectional study from Turkey. BMC Ophthalmol 2018; 18:91. [PMID: 29649995 PMCID: PMC5897948 DOI: 10.1186/s12886-018-0753-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2017] [Accepted: 03/29/2018] [Indexed: 01/06/2023] Open
Abstract
Background The aim of this study was to evaluate the prevalence of diabetic macular edema (DME) utilizing optical coherence tomography (OCT), and to clarify the effects of the systemic findings and risk factors on the development of DME. Methods This cross-sectional study was conducted in the departments of ophthalmology and endocrinology at the Dokuz Eylul University School of Medicine in Izmir, Turkey. The demographics, type and duration of diabetes mellitus, treatment modality, smoking and alcohol consumption habits, as well as the systemic blood pressure, renal functional tests, hemoglobulin A1c level, serum lipid profile, and 24-h urine albumin level were noted and statistically analyzed. The relationships between the systemic findings and DME were studied. Results Four-hundred and thirteen eyes of 413 diabetic patients who were examined between January 2011 and July 2012 were enrolled in this study. The prevalence of DME was 15.3% among the patients. The males exhibited DME significantly more frequently than the females (p = 0.031), and the duration of diabetes was significantly longer in those patients with DME (p < 0.001). Those patients without DME frequently used antihyperlipidemic drugs and had a higher level of high density lipoprotein cholesterol (p = 0.040 and p = 0.046, respectively). The patient’s alcohol consumption, nephropathy, neuropathy, previous cataract surgery, severity of diabetic retinopathy, and insulin usage were statistically significant factors with regard to the DME prevalence. Conclusions This study demonstrated the prevalence of DME in Turkey by utilizing OCT. The development of DME can be avoided or limited and the response to treatment may be improved by the regulation of the DME risk factors.
Collapse
Affiliation(s)
- Durgul Acan
- Department of Ophthalmology, Dokuz Eylul University School of Medicine, Izmir, Turkey.
| | - Mehmet Calan
- Department of Endocrinology and Metabolism, Dokuz Eylul University School of Medicine, Izmir, Turkey
| | - Duygu Er
- Department of Ophthalmology, Dokuz Eylul University School of Medicine, Izmir, Turkey
| | - Tugba Arkan
- Department of Endocrinology and Metabolism, Dokuz Eylul University School of Medicine, Izmir, Turkey
| | - Nilufer Kocak
- Department of Ophthalmology, Dokuz Eylul University School of Medicine, Izmir, Turkey
| | - Firat Bayraktar
- Department of Endocrinology and Metabolism, Dokuz Eylul University School of Medicine, Izmir, Turkey
| | - Suleyman Kaynak
- Department of Ophthalmology, Dokuz Eylul University School of Medicine, Izmir, Turkey
| |
Collapse
|
27
|
Bar-Oz D, Hecht I, Achiron A, Midlij M, Man V, Bar Dayan Y, Burgansky-Eliash Z. Glycemic Control and Quality of Life Following Cataract Surgery in Patients with Type 2 Diabetes and without Maculopathy. Curr Eye Res 2017; 43:96-101. [PMID: 29111818 DOI: 10.1080/02713683.2017.1383443] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Dor Bar-Oz
- Department of Ophthalmology, Edith Wolfson Medical Center and Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Idan Hecht
- Department of Ophthalmology, Edith Wolfson Medical Center and Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Asaf Achiron
- Department of Ophthalmology, Edith Wolfson Medical Center and Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Mohamad Midlij
- Department of Ophthalmology, Edith Wolfson Medical Center and Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Vitaly Man
- Department of Ophthalmology, Soroka University Medical Center, Ben-Gurion University, Beer-Sheva, Israel
| | - Yosefa Bar Dayan
- Diabetes Unit, Edith Wolfson Medical Center and Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Zvia Burgansky-Eliash
- Department of Ophthalmology, Edith Wolfson Medical Center and Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| |
Collapse
|
28
|
Petropoulos IN, Javed S, Azmi S, Khan A, Ponirakis G, Malik RA. Diabetic neuropathy and painful diabetic neuropathy in the Middle East and North Africa (MENA) region: Much work needs to be done. J Taibah Univ Med Sci 2016. [DOI: 10.1016/j.jtumed.2016.06.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
|
29
|
Abstract
The prevalence of type-2 diabetes mellitus (T2DM) has increased dramatically during the last 2 decades, a fact driven by the increased prevalence of obesity, the primary risk factor for T2DM. The figures for diabetes in the Arab world are particularly startling as the number of people with diabetes is projected to increase by 96.2% by 2035. Genetic risk factors may play a crucial role in this uncontrolled raise in the prevalence of T2DM in the Middle Eastern region. However, factors such as obesity, rapid urbanization and lack of exercise are other key determinants of this rapid increase in the rate of T2DM in the Arab world. The unavailability of an effective program to defeat T2DM has serious consequences on the increasing rise of this disease, where available data indicates an unusually high prevalence of T2DM in Arabian children less than 18 years old. Living with T2DM is problematic as well, since T2DM has become the 5th leading cause of disability, which was ranked 10th as recently as 1990. Giving the current status of T2DM in the Arab world, a collaborative international effort is needed for fighting further spread of this disease.
Collapse
|
30
|
Kizor-Akaraiwe NN, Ezegwui IR, Oguego N, Uche NJ, N. Asimadu I, Shiweobi J. Prevalence, Awareness and Determinants of Diabetic Retinopathy in a Screening Centre in Nigeria. J Community Health 2016; 41:767-71. [DOI: 10.1007/s10900-016-0151-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
31
|
Abstract
Diabetic retinopathy (DR) is a leading cause of vision-loss globally. Of an estimated 285 million people with diabetes mellitus worldwide, approximately one third have signs of DR and of these, a further one third of DR is vision-threatening DR, including diabetic macular edema (DME). The identification of established modifiable risk factors for DR such as hyperglycemia and hypertension has provided the basis for risk factor control in preventing onset and progression of DR. Additional research investigating novel risk factors has improved our understanding of multiple biological pathways involved in the pathogenesis of DR and DME, especially those involved in inflammation and oxidative stress. Variations in DR prevalence between populations have also sparked interest in genetic studies to identify loci associated with disease susceptibility. In this review, major trends in the prevalence, incidence, progression and regression of DR and DME are explored, and gaps in literature identified. Established and novel risk factors are also extensively reviewed with a focus on landmark studies and updates from the recent literature.
Collapse
Affiliation(s)
- Ryan Lee
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore ; Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Tien Y Wong
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore ; Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore ; Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Graduate Medical School, Singapore, Singapore
| | - Charumathi Sabanayagam
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore ; Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore ; Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Graduate Medical School, Singapore, Singapore
| |
Collapse
|
32
|
Lee R, Wong TY, Sabanayagam C. Epidemiology of diabetic retinopathy, diabetic macular edema and related vision loss. Eye Vis (Lond) 2015. [PMID: 26605370 DOI: 10.1186/s40662-015-0026-2+10.1186/s40662-015-0026-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Diabetic retinopathy (DR) is a leading cause of vision-loss globally. Of an estimated 285 million people with diabetes mellitus worldwide, approximately one third have signs of DR and of these, a further one third of DR is vision-threatening DR, including diabetic macular edema (DME). The identification of established modifiable risk factors for DR such as hyperglycemia and hypertension has provided the basis for risk factor control in preventing onset and progression of DR. Additional research investigating novel risk factors has improved our understanding of multiple biological pathways involved in the pathogenesis of DR and DME, especially those involved in inflammation and oxidative stress. Variations in DR prevalence between populations have also sparked interest in genetic studies to identify loci associated with disease susceptibility. In this review, major trends in the prevalence, incidence, progression and regression of DR and DME are explored, and gaps in literature identified. Established and novel risk factors are also extensively reviewed with a focus on landmark studies and updates from the recent literature.
Collapse
Affiliation(s)
- Ryan Lee
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore ; Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Tien Y Wong
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore ; Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore ; Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Graduate Medical School, Singapore, Singapore
| | - Charumathi Sabanayagam
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore ; Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore ; Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Graduate Medical School, Singapore, Singapore
| |
Collapse
|
33
|
Lee R, Wong TY, Sabanayagam C. Epidemiology of diabetic retinopathy, diabetic macular edema and related vision loss. Eye Vis (Lond) 2015; 2:17. [PMID: 26605370 PMCID: PMC4657234 DOI: 10.1186/s40662-015-0026-2] [Citation(s) in RCA: 823] [Impact Index Per Article: 91.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Accepted: 09/01/2015] [Indexed: 12/15/2022]
Abstract
Diabetic retinopathy (DR) is a leading cause of vision-loss globally. Of an estimated 285 million people with diabetes mellitus worldwide, approximately one third have signs of DR and of these, a further one third of DR is vision-threatening DR, including diabetic macular edema (DME). The identification of established modifiable risk factors for DR such as hyperglycemia and hypertension has provided the basis for risk factor control in preventing onset and progression of DR. Additional research investigating novel risk factors has improved our understanding of multiple biological pathways involved in the pathogenesis of DR and DME, especially those involved in inflammation and oxidative stress. Variations in DR prevalence between populations have also sparked interest in genetic studies to identify loci associated with disease susceptibility. In this review, major trends in the prevalence, incidence, progression and regression of DR and DME are explored, and gaps in literature identified. Established and novel risk factors are also extensively reviewed with a focus on landmark studies and updates from the recent literature.
Collapse
Affiliation(s)
- Ryan Lee
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore ; Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Tien Y Wong
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore ; Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore ; Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Graduate Medical School, Singapore, Singapore
| | - Charumathi Sabanayagam
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore ; Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore ; Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Graduate Medical School, Singapore, Singapore
| |
Collapse
|
34
|
Jingi AM, Nansseu JRN, Noubiap JJN, Bilong Y, Ellong A, Mvogo CE. Diabetes and visual impairment in sub-Saharan Africa: evidence from Cameroon. J Diabetes Metab Disord 2015; 14:21. [PMID: 25866740 PMCID: PMC4392737 DOI: 10.1186/s40200-015-0151-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2014] [Accepted: 03/19/2015] [Indexed: 12/19/2022]
Abstract
Background “Vision 2020 – the right to sight” is a program which purpose is to eliminate avoidable blindness by the year 2020 through the implementation of concrete action plans at the national and district levels. Accordingly, baseline data are needed for the planning, monitoring, follow-up and evaluation of this program. The present study aimed to better characterize visual impairment and blindness in Cameroonian diabetics by providing with baseline data on the prevalence and main causes of these affections. Methods This was a hospital-based cross-sectional study, conducted from October 2004 to October 2006 at the Department of Ophthalmology of the Douala General Hospital, Cameroon. We included 407 diabetic patients who were referred from diabetes clinics for ophthalmologic evaluation. Ophthalmologic data included visual acuity, intra-ocular pressure, fundoscopy and fluorescein angiography. Results The prevalence of blindness and poor vision were respectively 12.3% and 17.4% with regard to the worst eyes. Fifty nine (14.5%) patients were found with diabetic maculopathy, of whom 25.4% (15/59) had poor vision, and 25.4% (15/59) were blind. The prevalence of sight threatening retinopathy (severe non-proliferative and proliferative) was 17.4%. The degree of visual impairment was comparable in both diabetic types (p = 0.825), and it increased with the severity of retinopathy (p < 0.0001), as well as that of maculopathy (p <0.0001). The prevalence of glaucoma was 15% (61/407) when considering the worst eyes. The severity of visual impairment increased with the severity of glaucoma (p = 0.001). One hundred and twenty-one (29.7%) patients presented with cataract irrespective of its location or severity. Cataract was significantly associated with poor vision and blindness (p < 0.0001). Hypertensive retinopathy (4.9%), papillary ischaemia (2.7%), vaso-occlusive eye disease (2.5%), and age-related macular edema (2%) were the other potential causes of visual impairment and blindness encountered the most in our setting. Age ≥ 50 years, male sex, duration of diabetes and hypertension variously increased the risk of having glaucoma, cataract, diabetic retinopathy or maculopathy. Conclusion Poor vision and blindness are frequent in Cameroonian diabetics, and their causes are similar to those reported by various other surveys: mainly cataract, glaucoma, diabetic retinopathy and maculopathy.
Collapse
Affiliation(s)
- Ahmadou M Jingi
- Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
| | | | - Jean Jacques N Noubiap
- Internal Medicine Unit, Edéa Regional Hospital, PO Box 100, Edéa, Cameroon ; Medical Diagnostic Center, Yaoundé, Cameroon
| | - Yannick Bilong
- Department of Ophthalmology, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
| | - Augustin Ellong
- Department of Ophthalmology, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
| | - Côme Ebana Mvogo
- Department of Ophthalmology, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
| |
Collapse
|