Abstract
Diabetes and blindness are important health issues globally; we determined the prevalence of blindness, diabetic retinopathy, and other eye diseases in Nigerian-type 2 diabetics. A prospective, cross-sectional study was conducted on consenting type 2 diabetic patients who had scheduled comprehensive eye examination including dilated funduscopy with +78DS. Visual status was graded using the WHO criteria. Approval from Institutional Ethics Committee was obtained. Primary outcome measures were the prevalence and causes of blindness as well as prevalence of diabetic retinopathy. Secondary outcome measures were the presence of other eye diseases. Data were analyzed using SPSS version 13. Two hundred and sixty-six eyes of 133 type 2 diabetic patients aged 22–89 years were studied; 69 (51.9 %) were males while 64 (48.1 %) were females. Five (3.8 %) patients were blind while 27 (20.3 %) were visually impaired. Cataract was the leading cause of blindness (60 %) and visual impairment was found in 59.3 %. Diabetic retinopathy was present in 37 (27.8 %) diabetic patients of which 5 (3.8 %) were proliferative. Diabetic macular edema was present in 31 (23.3 %) patients. Severe visual impairment and blindness were commoner in those with diabetic retinopathy. Refractive error 67 (25.2 %), cataract 63 (23.7 %), and chronic glaucoma 44 (16.5 %) were the most prevalent non-diabetic retinopathy eye diseases. High prevalence of blindness, diabetic retinopathy, and other diseases are seen in type 2 diabetics. Health education, early diagnosis as well as treatment of diabetic retinopathy and other diseases will largely alleviate these ocular morbidities.
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References
Winter I, Yorston D (2011) Diabetic retinopathy: everybody’s business. Community Eye Health J 24:1–2
Van DS, Beulens JWJ, Van der SYT, Grobbee DE, Nealb B (2010) The global burden of diabetes and its complications; an emerging pandemic. Eur J Prev Cardiol 17:s3–s8
Abdull MM, Sivasubramaniam S, Murthy GVS, Gilbert C, Abubakar T, Ezelum C, Rabiu MM, on behalf of Nigeria National Blindness and Visual Impairment Study Group (2009) Causes of blindness and visual impairment in Nigeria: the Nigeria national blindness and visual impairment survey. IVOS 50:4114–4120
Hall V, Thomsein RW, Heriksen O, Lohse N (2011) Diabetes in Sub-Saharan Africa 1999–2011: epidemiology and public health implications a systematic review. BMC Public Health 11:564
International Diabetes Federation (IDF) Diabetes Atlas, 6th edn, IDF, 2014. www.idf.org. Accessed Sept 2015
Pascolini D, Marriotti SP (2011) Global estimates of visual impairment. Br J Ophthalmol 2011
Zhang X, Greff EW, Chang YJ et al (2008) Diabetes mellitus and visual impairment: national health and nutrition examination survey 1999–2004. Arch Ophthalmol 26:1421–1427
Congdon NG, Friedman DS, Lietman T (2003) Important causes of visual impairment in the world today. JAMA 290:2057–2060
Glover SJ, Burgess PI, Cohen DB et al (2012) Prevalence of diabetic retinopathy, cataract and visual impairment in patients with diabetes in sub Saharan Africa. Br J Ophthalmol 96:156–161
Jeganathan VS, Wang JJ, Wong TY (2008) Ocular associations of diabetes other than diabetic retinopathy. Diabetes Care 31:1903–1912
Farrel IC, Muran J (2014) Comparison of comorbidities in patients with prediabetes to those with diabetes mellitus type 2. Ir Med J 107:72–74
Nguyen HT, Luzio SD, Dolben J, West J, Beck L, Coates PA, Owens DR (1996) Dominant risk factors for retinopathy at clinical diagnosis in patients with type II diabetes mellitus. J Diabetes Complicat 10:211–219
Kyari F, Tafida A, Sivasubramaniam S, Murthy GV, Peto T, Gilbert CE, Nigeria National Blindness and Visual Impairment Study Group (2014) Prevalence and risk factors for diabetes and diabetic retinopathy: results from the Nigeria national blindness and visual impairment survey. BMC Public Health 14:1299
Idemyor V (2010) Diabetes in sub-Saharan Africa: health care perspectives, challenges, and the economic burden of disease. J Natl Med Assoc 102:650–653
Flessa S, Zembok A (2014) Costing of diabetes mellitus type II in Cambodia. Health Econ Rev 4:24
Bandello F, Casalino G, Loewenstein A, Goldstein M, Pelayes D, Battaglia Parodi M (2014) Pharmacological approach to diabetic macular edema. Ophthalmic Res 51:88–95
Pershing S, Enns EA, Matesic B, Owens DK, Goldhaber-Fiebert JD (2014) Cost-effectiveness of treatment of diabetic macular edema. Ann Intern Med 160:18–29
Patelli F, Radice P, Giacomotti E (2014) Diabetic macular edema. Dev Ophthalmol 54:164–173
Wang JE, Zhang RY, Chen RP et al (2013) Prevalence and risk factors for diabetic retinopathy in a high-risk Chinese population. BMC Public Health 13:633–639
Tapp RJ, Shaw JE, Harper CA, De Courten MP, Balkau B, McCarty DJ, Taylor HR, Welborn TA, Zimmet PZ, AusDiab Study Group (2003) The prevalence of and factors associated with diabetic retinopathy in Australian population. Diabetes Care 26:1731–1737
Mowatt L (2013) Diabetic retinopathy and its risk factors at the university Hospital in Jamaica. Middle East Afr J Ophthal 20:321–326
Li L, Wan XH, Zhao GH (2014) Metaanalysis of the risk of cataract in type 2 diabetes. BMC Ophthalmol 14:94–107
Murtha T, Cavellerano J (2007) The management of diabetic eye disease in the setting of cataract surgery. Curr Opin Ophthalmol 18:13–18
Patel SV, Holmes JM, Hodge DO, Burke JP (2005) Diabetes and hypertension in isolated sixth nerve palsy; a population based study. Ophthalmology 112:760–763
Lin SF, Lin PK, Chang FL, Tsai RK (2009) Transient hyperopia after intense treatment of hyperglycemia in newly diagnosed diabetes. Ophthalmologica 223:68–71
www.population.gov.ng/index.php/census. Accessed Sept 2015
Kahn Richard (2003) Follow up Report on the diagnosis of diabetes mellitus. The Expert Committee on the diagnosis and classification of diabetes mellitus. Diabetes care 26:3160–3167
World Health Organisation International statistical classification of diseases and related health problems 10th revision Current version. Version 2003 Chapter VII H54 Blindness and low vision. http://ophthaclassification.altervista.org/international-clinical-diabetic-retinopathy-disease-severity-scale/. Accessed Sept 2015
http://ophthaclassification.altervista.org/international-clinical-diabetic-retinopathy-disease-severity-scale/. Accessed Sept 2015
Colosia AD, Palencia R, Khan S (2013) Prevalence of hypertension and obesity in patients with type 2 diabetes mellitus in observational studies: a systematic literature review. Diabetes Metab Syndr Obes 6:327–338
Harris MD (2003) Psychosocial aspects of diabetes with an emphasis on depression. Curr Diabetes Rep 3:49–55
Rani PK, Raman R, Gella L, Kulothingan V, Sharma T (2012) Prevalence of visual impairment and associated risk factor in subjects with type 2 diabetes mellitus: Sankara Nethralaya diabetic retinopathy epidemiology and molecular genetic study(SN-DREAMS; Report 16). Middle East Afr J Ophthalmol 19:129–134
Al-Till MI, Al-Badour MD, Ajlouni KM (2005) Prevalence of blindness and visual impairment among Jordanian diabetics. Eur J Ophthalmol 15:62–68
Pollreisz A, Schmidt-Erfurth U (2010) Diabetic cataract pathogenesis, epidemiology and treatment. J Ophthalmol. doi:10.1155/2010/608751
Hashim Z, Zarina S (2012) Osmotic stress induced oxidative damage: possible mechanism of cataract formation in diabetes. J Diabetes Complicat 26:275–276
Bonovas S, Peponis V, Filioussi K (2004) Diabetes mellitus as a risk factor for primary open angle glaucoma; a metaanalysis. Diabet Med 21:609–614
Zhoun M, Wang W, Huang W, Zhang X (2014) Diabetes mellitus as a risk factor for open angle glaucoma; a systematic review and meta-analysis. PLoS One 9:e102972
Kim SJ, Equi R, Bressler NM (2007) Analysis of macular edema after cataract surgery in patients with diabetes using optical coherence tomography. Ophthalmology 114:881–889
Krepler K, Biowsky R, Schrey S, Jandrasits K, Wedrich A (2002) Cataract surgery in patients with diabetic retinopathy; visual outcome, progression of diabetic retinopathy and incidence of diabetic macular edema. Graefe’s Arch Clin Exp Ophthalmol 240:735–738
Raman R, Rani PK, Rachepalle SR, Uthra S, Kumaramanickavel G, Sharma T (2009) Prevalence of diabetic retinopathy in India. Sankara Nethralaya diabetic retinopathy epidemiology and molecular genetic study report 2. Ophthalmology 116:311–318
Owsley C, McGwin G Jr, Lee DJ, Lam BL, Friedman DS, Gower EW, Haller JA, Hark LA, Saaddine J, for the Innovative Network for Sight (INSIGHT) Research Group (2015) Diabetes eye screening in urban settings serving minority populations detection of diabetic retinopathy and other ocular findings using telemedicine. JAMA Ophthalmol 133:174–181
Patil S, Gogate P, Vora S et al (2014) Prevalence and causes of blindness, visual impairment and cataract surgical services in Sindhuburg district in the western coastal strip, India. Indian J Ophthalmol 62:240–245
Onakpoya OH, Adeoye AO, Kolawole BA (2010) Determinants of dilated eye examination among type 2 diabetics in Southwestern Nigeria. Eur J Int Med 21:176–179
Ellis D, Burges PH, Kayange P (2013) Management of diabetic retinopathy. Malawi Med J 25:116–120
Naidoo K, Gichuhi S, Basáñez M-G, Flaxman SR, Jonas JB, Keeffe J, Leasher JL, Pesudovs K, Price H, Smith JL, Turner HC, White RA, Wong TY, Resnikoff S, Taylor HR, Bourne RR, Vision Loss Expert Group of the Global Burden of Disease Study (2014) Prevalence and causes of vision loss in sub-Saharan Africa: 1990–2010. Br J Ophthalmol 98:612–618
Baris S, Banu B, Aysegul A, Murat I, Mehmet O, Umut S (2005) Effect of glyceamic control on refractive changes in diabetic patients with hyperglycemia. Cornea 24:531–537
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Grant—Part funding by Benjamin Osuntokun Trust.
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Onakpoya, O.H., Kolawole, B.A., Adeoye, A.O. et al. Visual impairment and blindness in type 2 diabetics: Ife-Ijesa diabetic retinopathy study. Int Ophthalmol 36, 477–485 (2016). https://doi.org/10.1007/s10792-015-0145-8
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DOI: https://doi.org/10.1007/s10792-015-0145-8