Diabetic retinopathy among patients attending university teaching hospitals adult hospital medical clinic in Lusaka

Abstract

Diabetic retinopathy (DR) is a common microvascular complication of diabetes mellitus and also a leading cause of visual impairment among people in the working age group. Retinopathy develops overtime in all diabetics and controlling the modifiable risk factors delays its onset and progression. This study was carried out to assess DR; its prevalence and associated clinical/demographic characteristics among patients attending the UTHs-Adult Hospital medical clinic in Lusaka, Zambia. This was a hospital-based cross-sectional study carried out from 18th December, 2018 to 16th April, 2019 at the adult medical diabetic clinic. Snellen visual acuity (VA), blood pressure, weight and height were measured as well as relevant demographic and medical information collected. Retinal images were captured after pupil dilatation and used for grading retinopathy using the International classification of DR scale. The worse eye was used to grade for DR. A total of 213 participants were studied with a female to male ratio of 2.3:1. The median age was 53 years and majority (183=85.2%) had type 2 diabetes. Median duration of diabetes was five years with insulin therapy being the most common (115=54.5%) diabetes control measure. Anti-hypertensive medication was being used by 87 participants (40.9%). Median glycated haemoglobin level was high at 8.1%. One hundred sixty-three participants (76.5%) had normal VA and six (2.8%) were blind. The prevalence of DR in this study was 47.4%; 95% CI 40.8%-54.2% (101 participants), with 8.9% (19 participants) having proliferative diabetic retinopathy. Diabetic macula oedema was present in 24 (11.3%; 95% CI 7.5%-16.1%). Duration of diabetes was the most significant (p<0.0001) association found with retinopathy; as well as alcohol intake and having diabetic foot (another microvascular complication). Even though 104 participants (51.1%) had the knowledge that diabetes affects the eyes, only 55 (25.8%) had had a dilated eye examination in the preceding twelve months. The study findings suggest that better advocacy for retinopathy screening and diabetes control needs to be implemented at the UTHs-Adult Hospital in Lusaka. Keywords: Diabetic retinopathy, prevalence, risk factors, dilated eye examination