Prevalence and Risk Factors for Diabetic Retinopathy The Singapore Malay Eye Study
ABSTRACT To describe the prevalence and risk factors of diabetic retinopathy in Asian Malays.
Population-based cross-sectional study.
Persons with diabetes of Malay ethnicity aged 40 to 80 years in Singapore.
Diabetes mellitus was defined as random glucose of 11.1 mmol/l or more, use of diabetic medication, or a physician diagnosis of diabetes. Retinal photographs taken from both eyes were graded for diabetic retinopathy using the modified Airlie House classification system.
Any diabetic retinopathy, retinopathy grades, macular edema, or vision-threatening retinopathy.
Of the 3261 persons who participated in this study, 757 (23.1%) had diabetes and gradable retinal photographs. In persons with diabetes, the overall prevalence of any retinopathy was 35.0% (95% confidence interval [CI], 28.2-43.4), the overall prevalence of macular edema was 5.7% (95% CI, 3.2-9.9), and the overall prevalence of vision-threatening retinopathy was 9.0% (95% CI, 5.8-13.8). Compared with men, women had significantly higher proportions with more severe diabetic retinopathy, moderate (12% vs. 4%) and severe (3% vs. 0.2%) nonproliferative retinopathy, proliferative retinopathy (7% vs. 2%), and vision-threatening retinopathy (13% vs. 3%). In multiple logistic regression, independent risk factors for any retinopathy were longer diabetes duration (odds ratio [OR], 1.07; 95% CI, 1.04-1.09, per year increase), higher hemoglobin A1(c) (OR, 1.21; 95% CI, 1.10-1.33, per % increase), hypertension (OR, 1.85; 95% CI, 1.04-3.30), and higher pulse pressure (OR, 1.34, 95% CI, 1.19-1.51, per 10-mmHg increase); older age (OR, 0.73; 95% CI, 0.57-0.93, per decade increase) and higher total cholesterol levels (OR, 0.75; 95% CI, 0.63-0.89, per 1-mmol/l increase) were protective of any retinopathy. Vision-threatening retinopathy additionally was associated with previous stroke (OR, 3.74; 95% CI, 1.24-11.26), cardiovascular disease (OR, 2.23; 95% CI, 1.08-4.62), and chronic kidney disease (OR, 4.45; 95% CI, 2.18-9.07). Female gender was not an independent risk factor for diabetic retinopathy after adjusting for metabolic and socioeconomic risk factors.
One in 10 Malay adults with diabetes in Singapore has vision-threatening diabetic retinopathy. Risk factors for retinopathy in this population are largely similar to white populations elsewhere, suggesting that control of these risk factors may reduce both the prevalence and impact of retinopathy.
- SourceAvailable from: Boon How Chew
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- "South Indian T2D women were found to have a higher prevalence of nephropathy, retinopathy and neuropathy . In Singapore, there was a significantly higher proportion of Malay women diabetes patients who suffered from retinopathy across the severity spectrum . "
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- "According to National Eye Database 2007, among 10,856 Malaysian populations with diabetes, 36.8% has any form of DR, of which 7.1% has proliferative diabetic retinopathy . In 2008, Singapore Malay Eye Study on 3261 persons with diabetes found 35.3% prevalence of any retinopathy, of which 6.8% had proliferative diabetic retinopathy . NPDR is the earliest form of DR caused by microvascular leakage away from the macula . "
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