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      Diabetic retinopathy among Omanis: Prevalence and clinical profile

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          Abstract

          PURPOSE:

          The aim of this study is to describe the prevalence, severity and clinical profile of diabetic retinopathy (DR) among Omani diabetic patients attending a tertiary care hospital.

          MATERIALS AND METHODS:

          This is a retrospective study involving the record review of diabetic patients attending the diabetes retina clinic of the National Diabetes and Endocrine Centre in the period between June 2015 and May 2016. Retinal evaluation of 442 native patients was conducted using direct ophthalmological examination and digital photography. DR was graded using the Early Treatment DR Study criteria. The statistical analysis was conducted using SPSS, version 20.

          RESULTS:

          The estimated total prevalence of DR was 31% (95% confidence interval: 26.6–35.3). Mild nonproliferative diabetic retinopathy (NPDR) constitutes 21.3%, while moderate-to-severe NPDR and proliferative diabetic retinopathy constitute 4.5% and 5.2%, respectively. The prevalence of vision-threatening diabetic retinopathy (VTDR) and diabetic maculopathy was 15.4% and 13.3%, respectively. Retinopathy was significantly associated with age, diabetes duration, Type 2 diabetes mellitus, coexisting comorbidities or complications, systolic blood pressure, glycated hemoglobin (HbA1c), fasting blood sugar, triglycerides, and albumin/creatinine ratio. In the regression analysis, age ( P = 0.02), duration ( P < 0.001), and HbA1c ( P < 0.001) were independently associated with DR.

          CONCLUSIONS:

          The prevalence of DR and VTDR among Omani diabetics is high. Age, duration of diabetes, and HbA1c are the risk factors for the development of DR among Omanis. This emphasizes the importance of planning resources for different modalities of treatment of DR to face the future challenge.

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          Most cited references42

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          Global prevalence of diabetes: estimates for the year 2000 and projections for 2030.

          The goal of this study was to estimate the prevalence of diabetes and the number of people of all ages with diabetes for years 2000 and 2030. Data on diabetes prevalence by age and sex from a limited number of countries were extrapolated to all 191 World Health Organization member states and applied to United Nations' population estimates for 2000 and 2030. Urban and rural populations were considered separately for developing countries. The prevalence of diabetes for all age-groups worldwide was estimated to be 2.8% in 2000 and 4.4% in 2030. The total number of people with diabetes is projected to rise from 171 million in 2000 to 366 million in 2030. The prevalence of diabetes is higher in men than women, but there are more women with diabetes than men. The urban population in developing countries is projected to double between 2000 and 2030. The most important demographic change to diabetes prevalence across the world appears to be the increase in the proportion of people >65 years of age. These findings indicate that the "diabetes epidemic" will continue even if levels of obesity remain constant. Given the increasing prevalence of obesity, it is likely that these figures provide an underestimate of future diabetes prevalence.
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            Grading diabetic retinopathy from stereoscopic color fundus photographs--an extension of the modified Airlie House classification. ETDRS report number 10. Early Treatment Diabetic Retinopathy Study Research Group.

            (1991)
            The modified Airlie House classification of diabetic retinopathy has been extended for use in the Early Treatment Diabetic Retinopathy Study (ETDRS). The revised classification provides additional steps in the grading scale for some characteristics, separates other characteristics previously combined, expands the section on macular edema, and adds several characteristics not previously graded. The classification is described and illustrated and its reproducibility between graders is assessed by calculating percentages of agreement and kappa statistics for duplicate gradings of baseline color nonsimultaneous stereoscopic fundus photographs. For retinal hemorrhages and/or microaneurysms, hard exudates, new vessels, fibrous proliferations, and macular edema, agreement was substantial (weighted kappa, 0.61 to 0.80). For soft exudates, intraretinal microvascular abnormalities, and venous beading, agreement was moderate (weighted kappa, 0.41 to 0.60). A double grading system, with adjudication of disagreements of two or more steps between duplicate gradings, led to some improvement in reproducibility for most characteristics.
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              Diabetic retinopathy in a multi-ethnic cohort in the United States.

              To describe the prevalence and risk factors of diabetic retinopathy in a multi-ethnic US population of whites, blacks, hispanics, and chinese. Cross-sectional study of 778 individuals from ages 45 to 85 years with diabetes, participating in the Multi-Ethnic Study of Atherosclerosis (MESA). Retinal photographs were obtained with a 45 degrees nonmydriatic digital fundus camera. Presence and severity of diabetic retinopathy were graded at a central reading center on the basis of a modification of the Airlie House classification system. All participants underwent a standardized interview, examination, and laboratory investigations. In this population with diabetes, the prevalence of any retinopathy was 33.2% and macular edema 9.0%. The prevalence of any diabetic retinopathy and macular edema was significantly higher in blacks (36.7% and 11.1%) and hispanics (37.4% and 10.7%) than in whites (24.8% and 2.7%) and chinese (25.7% and 8.9%) (P = .01 and P = .007, comparing racial/ethnic differences for retinopathy and macular edema, respectively). Significant independent predictors of any retinopathy were longer duration of diabetes, higher fasting serum glucose, use of diabetic oral medication or insulin, and greater waist-hip ratio. Race was not an independent predictor of any retinopathy. This study provides contemporary data on the prevalence of and risk factors for diabetic retinopathy among whites, blacks, hispanics, and chinese participating in the MESA.
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                Author and article information

                Journal
                Oman J Ophthalmol
                Oman J Ophthalmol
                OJO
                Oman Journal of Ophthalmology
                Wolters Kluwer - Medknow (India )
                0974-620X
                0974-7842
                May-Aug 2020
                28 May 2020
                : 13
                : 2
                : 76-83
                Affiliations
                [1 ] National Diabetes and Endocrine Centre, Royal Hospital, Seeb, Oman
                [2 ] Department of Research and Studies, Oman Medical Specialty Board, Muscat, Oman
                [3 ] National Diabetes and Endocrine Centre, Royal hospital, Muscat, Oman
                Author notes
                Address for correspondence: Dr. Puspalata Agroiya, National Diabetes and Endocrine Centre, Royal Hospital, P C 111, P. O. Box 1331, Seeb, Muscat, Oman. E-mail: pushpl007@ 123456yahoo.co.in
                Article
                OJO-13-76
                10.4103/ojo.OJO_225_2019
                7394070
                c1a90cf7-78c5-4338-b566-71474ffcac81
                Copyright: © 2020 Oman Ophthalmic Society

                This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

                History
                : 30 September 2019
                : 13 November 2019
                : 16 December 2019
                Categories
                Original Article

                Ophthalmology & Optometry
                diabetic retinopathy,oman,prevalence,risk factors,vision-threatening diabetic retinopathy

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