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- Title
Prevalence and severity of diabetic retinopathy at first presentation to vitreoretinal services in Bhutan: a 3-year national study.
- Authors
Rai, Bhim Bahadur; Essex, Rohan W.; Morley, Michael G.; Bernstein, Paul S.; van Kleef, Joshua P.; Maddess, Ted
- Abstract
Purpose: To determine the prevalence and severity of diabetic retinopathy (DR) at first presentation among diabetic patients attending national vitreoretinal (VR) services in Bhutan Study design: Retrospective cross-sectional study Methods: We included all diabetic patients in Bhutan who presented for retinal evaluation for the first time over a 3-year period (2013–2016). Data including demography, clinical details, diagnostic tests, and clinical staging of DR were analyzed. Results: A total of 843 diabetic patients, aged 57.2 ± 12.0 (range 18–86) years, were enrolled. The majority were male (452, 53.6%; cumulative frequency [cf] 391, 46.4%; P =.14) and from urban settings (570, 67.6%; cf 273; 32.4%) and did not have modern schooling (555, 65.8%). Hypertension was the most common systemic comorbidity (501, 59.4%). The prevalence of DR was 42.7%, with mild nonproliferative DR (NPDR) being the most common type (187, 51.9%), followed by moderate NPDR (88, 24.4%) and proliferative DR (45, 12.5%). In addition, 120 patients had clinically significant macular edema (CSME), with a prevalence of 14.2%. Best-corrected visual acuity (BCVA) of 6/60 or worse occurred in 231 eyes (13.7%), and 41 patients (4.86%) had BCVA of 6/60 or worse bilaterally due to DR/CSME. A logistic regression model indicated that the major determinant of DR was the duration of diabetes, the odds rising by 1.27× with each year of disease (P <.0001). Conclusion: The prevalence of DR, including CSME, was high. Although a national DR screening program is established in Bhutan, there is a need to accelerate health education, community screening, and referral systems to reduce the prevalence of DR and CSME.
- Subjects
BHUTAN; DIABETIC retinopathy; MACULAR edema; PEOPLE with diabetes; HEALTH education; VISUAL acuity; LOGISTIC regression analysis
- Publication
Japanese Journal of Ophthalmology, 2023, Vol 67, Issue 3, p287
- ISSN
0021-5155
- Publication type
Article
- DOI
10.1007/s10384-023-00989-6