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. 1998 Aug;82(8):901–906. doi: 10.1136/bjo.82.8.901

Prevalence and risk factors for diabetic retinopathy among Omani diabetics

O Haddad 1, M K Saad 1
PMCID: PMC1722699  PMID: 9828774

Abstract

AIMS—To study the prevalence of diabetic retinopathy in a population of patients attending a diabetic clinic and to evaluate the medical risk factors underlying its development.
METHODS—500 randomly selected diabetic patients attending the diabetes clinic in Al Buraimi hospital were referred to the ophthalmology department where they were fully evaluated for the absence or presence of retinopathy. Any retinopathy present was graded as mild non-proliferative retinopathy (NPR), moderate-severe NPR, and proliferative retinopathy. Several risk factors were then evaluated in order to delineate those related to occurrence of retinopathy in general as well as to the different grades of retinopathy in particular.
RESULTS—Diabetic retinopathy was detected in 212 patients (42.4%), with mild NPR present in 128 patient (25.6% of the total population), moderate-severe NPR in 20 patients (4%), and proliferative diabetic retinopathy present in 64 patients (12.8%). Factors significantly related to occurrence of retinopathy were age of the patient, duration of diabetes, presence of ischaemic heart disease, presence of hypertension, a high fasting capillary glucose level as well as elevated serum levels of urea, creatinine, cholesterol, and triglycerides. After adjustment for covariates, it was found that duration of diabetes was the only risk factor associated with mild NPR, while high diastolic blood pressure and high levels of serum creatinine, cholesterol, and triglycerides were significantly associated with the occurrence of proliferative retinopathy.
CONCLUSIONS—In addition to glycaemic control, lowering of blood lipids as well as diastolic blood pressure (in hypertensive patients) may be effective in lowering the incidence of retinopathy in compromised patients.

 Keywords: diabetic retinopathy; Oman; diabetics

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Selected References

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  1. Agardh E., Torffvit O., Agardh C. D. The prevalence of retinopathy and associated medical risk factors in type I (insulin-dependent) diabetes mellitus. J Intern Med. 1989 Jul;226(1):47–52. doi: 10.1111/j.1365-2796.1989.tb01352.x. [DOI] [PubMed] [Google Scholar]
  2. Aiello L. M., Rand L. I., Briones J. C., Wafai M. Z., Sebestyen J. G. Diabetic retinopathy in Joslin Clinic patients with adult-onset diabetes. Ophthalmology. 1981 Jul;88(7):619–623. doi: 10.1016/s0161-6420(81)34982-3. [DOI] [PubMed] [Google Scholar]
  3. Alwan A., King H. Diabetes in the Eastern Mediterranean (Middle East) region: the World Health Organization responds to a major public health challenge. Diabet Med. 1995 Dec;12(12):1057–1058. doi: 10.1111/j.1464-5491.1995.tb00421.x. [DOI] [PubMed] [Google Scholar]
  4. Asfour M. G., Lambourne A., Soliman A., Al-Behlani S., Al-Asfoor D., Bold A., Mahtab H., King H. High prevalence of diabetes mellitus and impaired glucose tolerance in the Sultanate of Oman: results of the 1991 national survey. Diabet Med. 1995 Dec;12(12):1122–1125. doi: 10.1111/j.1464-5491.1995.tb00431.x. [DOI] [PubMed] [Google Scholar]
  5. Brinchmann-Hansen O., Dahl-Jørgensen K., Sandvik L., Hanssen K. F. Blood glucose concentrations and progression of diabetic retinopathy: the seven year results of the Oslo study. BMJ. 1992 Jan 4;304(6818):19–22. doi: 10.1136/bmj.304.6818.19. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Chen M. S., Kao C. S., Chang C. J., Wu T. J., Fu C. C., Chen C. J., Tai T. Y. Prevalence and risk factors of diabetic retinopathy among noninsulin-dependent diabetic subjects. Am J Ophthalmol. 1992 Dec 15;114(6):723–730. doi: 10.1016/s0002-9394(14)74051-6. [DOI] [PubMed] [Google Scholar]
  7. Collins V. R., Dowse G. K., Plehwe W. E., Imo T. T., Toelupe P. M., Taylor H. R., Zimmet P. Z. High prevalence of diabetic retinopathy and nephropathy in Polynesians of Western Samoa. Diabetes Care. 1995 Aug;18(8):1140–1149. doi: 10.2337/diacare.18.8.1140. [DOI] [PubMed] [Google Scholar]
  8. Engerman R., Bloodworth J. M., Jr, Nelson S. Relationship of microvascular disease in diabetes to metabolic control. Diabetes. 1977 Aug;26(8):760–769. doi: 10.2337/diab.26.8.760. [DOI] [PubMed] [Google Scholar]
  9. Erasmus R. T., Alanamu R. A., Bojuwoye B., Oluboyo P., Arije A. Diabetic retinopathy in Nigerians: relation to duration of diabetes, type of treatment and degree of control. East Afr Med J. 1989 Apr;66(4):248–254. [PubMed] [Google Scholar]
  10. Fernandez-Vigo J., Sanchez Macho J., Diaz Rey A., Barros J., Tome M., Bueno J. The prevalence of diabetic retinopathy in northwest Spain. An epidemiological study of diabetic retinopathy in Galicia. I. Acta Ophthalmol (Copenh) 1993 Feb;71(1):22–26. doi: 10.1111/j.1755-3768.1993.tb04954.x. [DOI] [PubMed] [Google Scholar]
  11. Fernando D. J., Siribaddana S., De Silva, Subasinge Z. Prevalence of retinopathy in a Sri Lankan diabetes clinic. Ceylon Med J. 1993 Sep;38(3):120–123. [PubMed] [Google Scholar]
  12. González Villalpando M. E., González Villalpando C., Arredondo Pérez B., Stern M. P. Diabetic retinopathy in Mexico. Prevalence and clinical characteristics. Arch Med Res. 1994 Autumn;25(3):355–360. [PubMed] [Google Scholar]
  13. Henricsson M., Nilsson A., Groop L., Heijl A., Janzon L. Prevalence of diabetic retinopathy in relation to age at onset of the diabetes, treatment, duration and glycemic control. Acta Ophthalmol Scand. 1996 Dec;74(6):523–527. doi: 10.1111/j.1600-0420.1996.tb00727.x. [DOI] [PubMed] [Google Scholar]
  14. Heriot W. J., Borger J. P., Zimmet P., King H., Taylor R., Raper L. R. Diabetic retinopathy in a natural population. Aust J Ophthalmol. 1983 Aug;11(3):175–179. [PubMed] [Google Scholar]
  15. Janka H. U., Warram J. H., Rand L. I., Krolewski A. S. Risk factors for progression of background retinopathy in long-standing IDDM. Diabetes. 1989 Apr;38(4):460–464. doi: 10.2337/diab.38.4.460. [DOI] [PubMed] [Google Scholar]
  16. Jensen T., Deckert T. Diabetic retinopathy, nephropathy and neuropathy. Generalized vascular damage in insulin-dependent diabetic patients. Horm Metab Res Suppl. 1992;26:68–70. [PubMed] [Google Scholar]
  17. Jerneld B., Algvere P. Relationship of duration and onset of diabetes to prevalence of diabetic retinopathy. Am J Ophthalmol. 1986 Oct 15;102(4):431–437. doi: 10.1016/0002-9394(86)90069-3. [DOI] [PubMed] [Google Scholar]
  18. Khan A. J. Prevalence of diabetic retinopathy in Pakistani subjects. A pilot study. J Pak Med Assoc. 1991 Mar;41(3):49–50. [PubMed] [Google Scholar]
  19. Klein R., Klein B. E., Moss S. E., Davis M. D., DeMets D. L. Glycosylated hemoglobin predicts the incidence and progression of diabetic retinopathy. JAMA. 1988 Nov 18;260(19):2864–2871. [PubMed] [Google Scholar]
  20. Klein R., Klein B. E., Moss S. E., Davis M. D., DeMets D. L. Is blood pressure a predictor of the incidence or progression of diabetic retinopathy? Arch Intern Med. 1989 Nov;149(11):2427–2432. [PubMed] [Google Scholar]
  21. Klein R., Klein B. E., Moss S. E., Davis M. D., DeMets D. L. The Wisconsin epidemiologic study of diabetic retinopathy. III. Prevalence and risk of diabetic retinopathy when age at diagnosis is 30 or more years. Arch Ophthalmol. 1984 Apr;102(4):527–532. doi: 10.1001/archopht.1984.01040030405011. [DOI] [PubMed] [Google Scholar]
  22. Klein R., Klein B. E., Moss S. E. The Wisconsin epidemiological study of diabetic retinopathy: a review. Diabetes Metab Rev. 1989 Nov;5(7):559–570. doi: 10.1002/dmr.5610050703. [DOI] [PubMed] [Google Scholar]
  23. Klein R., Moss S. E., Klein B. E. Is gross proteinuria a risk factor for the incidence of proliferative diabetic retinopathy? Ophthalmology. 1993 Aug;100(8):1140–1146. doi: 10.1016/s0161-6420(93)31514-9. [DOI] [PubMed] [Google Scholar]
  24. Marshall G., Garg S. K., Jackson W. E., Holmes D. L., Chase H. P. Factors influencing the onset and progression of diabetic retinopathy in subjects with insulin-dependent diabetes mellitus. Ophthalmology. 1993 Aug;100(8):1133–1139. doi: 10.1016/s0161-6420(13)31517-6. [DOI] [PubMed] [Google Scholar]
  25. McCance D. R., Hadden D. R., Atkinson A. B., Archer D. B., Kennedy L. Long-term glycaemic control and diabetic retinopathy. Lancet. 1989 Oct 7;2(8667):824–828. doi: 10.1016/s0140-6736(89)92996-6. [DOI] [PubMed] [Google Scholar]
  26. Mouton D. P., Gill A. J. Prevalence of diabetic retinopathy and evaluation of risk factors. A review of 1,005 diabetic clinic patients. S Afr Med J. 1988 Oct 15;74(8):399–402. [PubMed] [Google Scholar]
  27. Teuscher A., Schnell H., Wilson P. W. Incidence of diabetic retinopathy and relationship to baseline plasma glucose and blood pressure. Diabetes Care. 1988 Mar;11(3):246–251. doi: 10.2337/diacare.11.3.246. [DOI] [PubMed] [Google Scholar]
  28. Weber B., Burger W., Hartmann R., Hövener G., Malchus R., Oberdisse U. Risk factors for the development of retinopathy in children and adolescents with type 1 (insulin-dependent) diabetes mellitus. Diabetologia. 1986 Jan;29(1):23–29. doi: 10.1007/BF02427276. [DOI] [PubMed] [Google Scholar]
  29. Yip J., Mattock M. B., Morocutti A., Sethi M., Trevisan R., Viberti G. Insulin resistance in insulin-dependent diabetic patients with microalbuminuria. Lancet. 1993 Oct 9;342(8876):883–887. doi: 10.1016/0140-6736(93)91943-g. [DOI] [PubMed] [Google Scholar]

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