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Prevalence of diabetic retinopathy in Peruvian patients with type 2 diabetes: results of a hospital-based retinal telescreening program

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Date
2011
Author
Villena, Jaime E
Yoshiyama, Christian A
Sßnchez, Javier E
Hilario, Nélida L
Merin, Lawrence M
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Abstract
OBJECTIVE: To estimate the prevalence of diabetic retinopathy (DR) in patients with type 2 diabetes and to determine any association with clinical factors. METHODS: This hospital-based screening project was designed to prospectively detect the presence of DR in patients with type 2 diabetes by grading images acquired with a digital retinal camera. RESULTS: Of 1 311 patients screened, appropriate retinal images were obtained in 1 222 subjects (93.2 percent). DR was detected in 282 patients (23.1 percent) [95 percent confidence interval (CI): 20.71-25.44]; 249 patients (20.4 percent) (95 percent CI: 18.1-22.6) had nonproliferative DR and 33 (2.7 percent) (95 percent CI: 1.8-3.6) had proliferative DR. In 32 patients (11.3 percent), DR was unilateral. The frequency of DR was the same in both sexes. Prevalence of blindness was twice as frequent in patients with DR as in those without it (9.4 percent and 4.6 percent, respectively) (P = 0.001). The frequency of DR at diagnosis was 3.5 percent and it increased with the duration of diabetes. DR was more frequent in patients with arterial hypertension, macrovascular or microvascular complications, and hemoglobin A1c (HbA1c) 7.0 percent and in those treated with insulin or sulfonylureas. It was less prevalent in those with HbA1c 7.0 percent, with greater body mass index, and who had been treated with metformin. CONCLUSIONS: The prevalence of DR in these patients with type 2 diabetes was 23.1 percent. Nonproliferative retinopathy accounted for 77.0 percent of cases. Although less prevalent than in a previous report, it doubled the frequency of blindness in the people affected. A national screening DR program should be considered in order to detect this prevalent condition early and treat it in a timely fashion.(AU)
 
OBJETIVO: Calcular la prevalencia de la retinopatía diabética en pacientes con diabetes tipo 2 y determinar su asociación con factores clínicos. MÉTODOS: Este proyecto de detección sistemßtica hospitalaria se dise±ó para detectar de manera prospectiva la presencia de retinopatía diabética en pacientes con diabetes tipo 2 mediante la valoración de imßgenes obtenidas con una cßmara digital para fotografía retiniana. RESULTADOS: Se evaluó a 1 311 pacientes y se obtuvieron imßgenes retinianas apropiadas en 1 222 de ellos (93,2 por ciento). Se detectó retinopatía diabética en 282 pacientes (23,1 por ciento) (intervalo de confianza [IC] de 95 por ciento: 20,71-25,44): 249 pacientes (20,4 por ciento) (IC de 95 por ciento: 18,1-22,6) tenían retinopatía diabética no proliferativa y 33 (2,7 por ciento) (IC 95 por ciento: 1,8-3,6) presentaban retinopatía diabética proliferativa. En 32 pacientes (11,3 por ciento), la retinopatía diabética era unilateral. La frecuencia de retinopatía diabética fue la misma en ambos sexos. La prevalencia de ceguera fue del doble en los pacientes con retinopatía diabética que en aquellos sin ella (9,4 por ciento y 4,6 por ciento, respectivamente) (P = 0,001). La frecuencia de retinopatía diabética en el momento del diagnóstico fue de 3,5 por ciento y aumentó con la duración de la diabetes. La retinopatía diabética fue mßs frecuente en los pacientes con hipertensión arterial, complicaciones macrovasculares o microvasculares y hemoglobina A1c (HbA1c) 7,0 por ciento, y en aquellos tratados con insulina o sulfonilureas. Fue menos prevalente en los pacientes con HbA1c 7,0 por ciento, en aquellos con mayor índice de masa corporal y en los tratados con metformina. CONCLUSIONES: La prevalencia de retinopatía diabética en estos pacientes con diabetes tipo 2 fue de 23,1 por ciento. La retinopatía no proliferativa representó 77,0 por ciento de los casos. Aunque la prevalencia de la ceguera fue menor que en un informe anterior...(AU)
 
Series
Rev Panam Salud Publica;30(5),nov. 2011
Subject
Diabetic Retinopathy; Diabetes Mellitus; Telemedicine; Peru; Retinopatía diabética; Diabetes Mellitus; Telemedicina; Peru; Diabetes Mellitus Tipo 2; Retinopatia Diabética; Hospitais Públicos; Hospitais Universitários; Programas de Rastreamento; Retina; Telemedicina; Cegueira; Cegueira; Comorbidade; Diabetes Mellitus Tipo 2; Diabetes Mellitus Tipo 2; Angiopatias Diabéticas; Retinopatia Diabética; Retinopatia Diabética; Fundo de Olho; Hemoglobina A Glicosilada; Hipertensão; Hipoglicemiantes; Cooperação Internacional; Estudos de Intervenção; Metformina; Peru; Fotografia; Prevalência; Estudos Prospectivos; Acuidade Visual
URI
http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S1020-49892011001100002
https://iris.paho.org/handle/10665.2/9449
Citation
Villena, Jaime E,Yoshiyama, Christian A,Sßnchez, Javier E,Hilario, Nélida L,Merin, Lawrence M (2011) Prevalence of diabetic retinopathy in Peruvian patients with type 2 diabetes: results of a hospital-based retinal telescreening program. Rev Panam Salud Publica;30(5) 408-414,nov. 2011. Retrieved from http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S1020-49892011001100002
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