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

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