Korean J Ophthalmol.  2022 Feb;36(1):26-35. 10.3341/kjo.2021.0040.

Prevalence and Associated Factors of Diabetic Retinopathy among Type 2 Diabetes Mellitus Patients in Brunei Darussalam: A Cross-sectional Study

Affiliations
  • 1Department of Ophthalmology, Pengiran Muda Mahkota Pengiran Muda Haji Al-Muhtadee Billah, Tutong Hospital, Tutong, Brunei Darussalam
  • 2Department of Medicine, RIPAS and PAPRSB IHS Pengiran Muda Mahkota Pengiran Muda Haji Al-Muhtadee Billah, Tutong Hospital, Tutong, Brunei Darussalam
  • 3Department of Ophthalmology, RIPAS Hospital, Bandar Seri Begawan, Brunei Darussalam
  • 4Department of Community Medicine, Calicut Medical College, Kerala, India
  • 5Pengiran Anak Puteri Rashidah Sa’adatul Bolkiah Institute of Health Sciences, Universiti Brunei Darussalam, Gadong, Brunei Darussalam

Abstract

Purpose
To determine the prevalence of diabetic retinopathy (DR) and the factors associated with retinopathy among type 2 diabetes mellitus (DM) patients in Brunei Darussalam.
Methods
Cross-sectional study of all type 2 DM patients who attended diabetic eye screening over a 3-month period at one of four government hospitals. We assessed association between DR with the following variables: age, sex, glycated hemoglobin (HbA1c), duration of DM, hypertension, hyperlipidemia, and microalbuminuria.
Results
There were 341 patients (female, 58.9%; mean age, 55.3 ± 11.9 years) with a mean duration of DM of 9.4 ± 7.4 years and mean serum HbA1c of 8.4% ± 1.9%. The overall prevalence of any DR was 22.6% (95% confidence interval, 18.8–27.1) with prevalence rates of 4.1% (95% confidence interval, 2.1–6.4) for proliferative DR and 9.7% (95% confidence interval, 6.8–13.2) for vision-threatening DR. Multivariate analysis showed that DR was significantly associated with certain age groups (reduced in older age groups), longer duration of DM (11 years or more), poor control (HbA1c >9.0%) and presence of any microalbuminuria.
Conclusions
DR affects one in five patients with DM in Brunei Darussalam, comparable to rates reported for other Asian populations. It is especially worrying that one in ten patients with DM had vision-threatening DR. DR was significantly associated with longer duration of DM, poor control and presence of microalbuminuria but reduced in older age groups. It is important to advocate good control right from the time of diagnosis of DM and institute timely and effective management of retinopathy. DR was significantly associated with longer duration of DM, poor control of diabetes, and presence of microalbuminuria but reduced in older age groups.

Keyword

Asians; Diabetic retinopathy; Prevalence; Risk factors; Type 2 diabetes mellitus
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