Prevalence of diabetic retinopathy and associated risk factors in diabetic type II patients in Ajdabiya, Libya

Diabetic retinopathy (DR) is One of the most wellknown microvascular complications of diabetes mellitus (DM) and is a frequent side effect of untreated diabetes that can lead to blindness and visual impairment. This study was conducted to assess the prevalence of diabetic retinopathy and associated factors among type 2 diabetic patients. A cross sectional study was done at Ajdabiya diabetic center from November 2023 to January 2024. Subjects and Methods: 52 patients (104 eyes) with T2DM were included in this study, their fasting blood sugar and glycosylated hemoglobin level, lipid profile measured.in addition to fundus examination (done by noncontact +90-diopter lens), fundus photographs taken by Non-Mydriatic Fundus Camera TFC-1000. Around 61 eyes (58.7%) had diabetic retinopathy, 27 eyes (26%) had back ground DR, 6 eyes (5.8 %) had pre-proliferative DR, 4 eyes (3.8%) had proliferative DR, 2 eyes (1.9%) had advanced diabetic eye disease, 22 eyes (21.2%) had CSME. Their ages ranges between 36­74 years with mean (58.90) years, (26.9%) were males, (73.1%) were females. There was a significant association between the development of DR and duration of DM (p=0.003), The FBS levels were also determined to be a significant risk factor for DR (p = 0.031), also LDL with (p=0.039). No other factors were found to have a significant association with DR. In this study more than half of diabetic patients had diabetic retinopathy. There was a significant association between the development of DR and duration of DM, FBS, LDL levels, there was no significant relation between diabetic retinopathy and hypertension, HgA1c Serum cholesterol or triglyceride levels or previous cataract surgery.

Time to Diabetic Retinopathy and Its Risk Factors among Diabetes Mellitus Patients in Jimma University Medical Center, Jimma, Southwest Ethiopia

Diabetic retinopathy is a complication of diabetes, caused by high blood sugar levels damaging the eye. Globally, diabetic retinopathy affects more than 103.12 million people. Diabetic retinopathy is among the leading causes of vision loss at the global level, including in Ethiopia. Therefore, the study aimed to assess the time to develop diabetic retinopathy and identify factors associated with diabetic retinopathy among diabetes patients. METHODS: A retrospective study was conducted from September 1, 2021, to January 30, 2022. Data was collected using semi structured questionnaire. The Cox proportional hazard model were used to determine the median time to develop diabetic retinopathy and identify predictors of diabetic retinopathy. Data was analyzed using R software. RESULTS: A total of 373 diabetes patients were included in this study. The prevalence of diabetic retinopathy was 41.3%. The median time was 41 months, ranging from 39 to 73 months. Elder age (HR=3.17, 95%CI: 1.53, 6.58), being male (HR=2.34, 95%CI: 1.35,6.15), previous family history of diabetes (HR=4.16, 95%CI: 2.19, 8.37), longer duration of diabetes (HR=2.86, 95%CI: 1.41, 5.31) received only insulin therapy (HR=3.91, 95%CI: 1.36, 7.94), and high systolic blood pressure (HR=2.32; 95%CI: 1.12, 4.39) were statistically significant factors related to development of diabetes retinopathy. CONCLUSIONS: More than half of diabetic patinets in this study were developed retinopathy diabetes within a few months of being diagnosed. As a result, we advocate that the best way to preserve our vision from diabetic retinopathy is to maintain our diabetes under control, and the high-risk population receive early screening for diabetes

Aspects angiofluorographiques de la rétinopathie diabétique

Introduction : La rétinopathie diabétique (RD) est une cause majeure de malvoyance et de cécité due à une microangiopathie après 10 à 20 ans d'évolution du diabète. Nous avons évalué la fréquence et les aspects angiographiques de la rétinopathie diabétique en fonction du type du diabète.Patients et Méthodes : Une étude descriptive et transversale, conduite de juin 2014 à décembre 2015 (18 mois) au Centre Hospitalier et Universitaire de Brazzaville avec la collaboration du Centre Médical Optique de Brazzaville. 84 patients diabétiques après un examen ophtalmologique complet ont bénéficié d'une angiofluorographie. L'interprétation des résultats était faite selon la classification Early Treatment Diabetic Retinopathy Study.Résultats : 39 Diabétiques avaient une rétinopathie (46,43%) pour un total de 78 yeux. Il s'agissait de 18 hommes (46,15%) et 21 femmes (53,85%), d'âge moyen 43,06 ± 15, 43 ans, extrêmes de 23 et 72 ans. La durée moyenne d'évolution du diabète était de 9,59 ± 4,34 ans. La moitié des patients avaient un diabète datant de 6 à 11 ans. Le diabète non insulinodépendant (DNID) était présent dans 25 cas soit 64,1% et insulinodépendant dans 14 cas soit 35,9%. 12 malades soit 30,76% avaient une hypertension artérielle. 10 yeux (12,65%) avaient une acuité visuelle inférieure à 1/10. Les lésions retrouvées en angiographie étaient une rétinopathie diabétique non proliférante (RDNP) aux deux yeux dans 23 cas (58,98%), à un œil dans 2 cas (5,12%) ; une rétinopathie diabétique proliférante (RDP) aux deux yeux chez 12 patients (30,77%) et à un œil dans 2 cas. La RDNP était retrouvée chez 51,28% des DNID contre 7,69% des DID. La RDP était présente chez 28,20% des DID et 12, 82% chez les DNID. 10 patients soit 25,64% présentaient un œdème maculaire non cystoïde.Conclusion : L'angiographie est un examen complémentaire indispensable au diagnostic, au suivi et à la prise en charge thérapeutique par photocoagulation de la rétinopathie diabétique. Elle ne saurait remplacer le fond d'œil qui est systématique au cours de l'examen ophtalmologique pour tout diabétique, afin de dépister la RD et d'éviter des complications qui sont des causes de cécité et de malvoyance

Effectiveness of a targeted education module for healthcare professionals attending a diabetic retinopathy training session in Zimbabwe

The Zimbabwe Diabetes Retinopathy Telemedicine Project (ZRTP) was created to develop a pilot programme to screen for diabetic retinopathy among patients attending a diabetes clinic in a public hospital. As part of the project, mid-level healthcare professionals (HCPs) attended one of four half-day training sessions in Harare, Zimbabwe; and took a five-question quiz before and after a 40-minute lecture reviewing the pathophysiology of diabetes and the detection and effects of diabetic retinopathy. Analysis of the pre- and post-lecture quiz results suggest that mid-level HCPs are deficient in some basic knowledge about diabetic retinopathy and diabetes, but this could be significantly improved by a relatively brief but focused lecture session

Compliance with diabetic retinopathy screening in a Nigerian tertiary hospital

There is little information on default rates and reasons for retinal screening in diabetes. We prospectively studied 179 type 2 diabetic patients referred for screening at a tertiary Nigerian medical centre. Defaulting occurred in 100 patients, i.e. over half (56%). Defaulting was associated with not having had a previous eye examination (p=0.027) and either a short (<1 year) or medium (6­10 year) duration of diabetes (p=0.001). Location of residence, level of education, diabetes treatment, age and gender did not correlate with screening compliance. We recommend that screening be carried out as soon as possible after diagnosis, which may improve future compliance

An Evaluation of the Screening for Retinopathy of Prematurity in Very-Low-Birth-Weight Babies at a Tertiary Hospital in Johannesburg; South Africa

Background. Retinopathy of prematurity (ROP) is a leading cause of blindness for very-low-birth-weight (VLBW; 1 500 g) babies. ROP screening identifies babies that require treatment to prevent major visual impairment.Objectives. To evaluate the screening for ROP at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH) by reviewing the number of babies screened according to the CMJAH guidelines; the grades of ROP found and the treatment modality received. Methods. This was a retrospective record review of VLBW babies born between 1 January 2013 and 31 December 2013 at CMJAH; whether inborn or transferred in. The babies were divided into two groups based on age at final outcome. Final outcome was defined as death; discharge or transfer out of the unit. The 'early' outcome group had their final outcome before day 28 of life. The 'late' outcome group had their final outcome at day 28 or more of life. The early outcome group qualified for outpatient ROP screening and the late outcome group qualified for inpatient ROP screening.Results. There were a total of 572 VLBW babies at CMJAH during this time period. The babies had a mean birth weight of 1 127 (standard deviation (SD) 244.75) g and gestational age of 29 (2.743) weeks. The mean duration of stay was 29 (21.66) days and there were 309 female babies. Of these 572 babies; 304 comprised the early outcome group and 268 comprised the late outcome group. In the early outcome group babies who were transferred out of the unit or died were excluded; therefore the remaining 147 babies discharged home qualified for outpatient ROP screening. Inpatient ROP screening was carried out in 36/147 (24.4%) of these babies (not in accordance with ROP screening guidelines). ROP was documented in 4/36 (11.1%). Outpatient ROP screening records were unavailable. Exclusions from the late outcome group included five babies. In the late outcome group 111/263 (42.2%) were screened for ROP. ROP was found in 17%. One baby required treatment with intravitreal antivascular endothelial growth factor (VEGF) and three babies required surgery. Conclusions. More than half of the babies in the late outcome group were not screened during their stay (57.8%). More than one-third of babies were discharged prior to reaching the current recommended age for screening. Efforts need to be intensified to identify and screen all eligible babies prior to discharge. Outpatient ROP screening is not well documented; therefore prevalence cannot be established

Facteurs associes a la neuropathie diabetique a l'hopital national de Lamorde (Niamey-Niger)

OBJECTIFS. Identifier les facteurs associes a la neuropathie chez les patients diabetiques suivis a l'Hopital National de Lamorde. MeTHODES. Il s'agit d'une etude transversale; prospective sur une duree de 6 mois (Avril a Octobre 2014). Ont ete inclus les patients diabetiques vus en consultation durant la periode d'etude. Le score de Michigan neuropathy screening instrument(MNSI) a permis d'etablir le diagnostic de neuropathie peripherique et la douleur neuropathique a ete diagnostiquee sur la base du score DN4. ReSULTATS. Sur 200 patients inclus; 46% avaient une neuropathie peripherique dont 24% une douleur neuropathique. La survenue de la neuropathie peripherique est significativement correlee au diabete de type 2; a l'age des patients; au sexe masculin; a l'anciennete du diabete et a un bas niveau socio-economique. Une association au desequilibre glycemique a ete observe chez 46;2 % des cas mais non significative (p=0;055). La neuropathie etait egalement associee a la nephropathie; a une retinopathie diabetique et a la dysfonction erectile chez hommes.CONCLUSION. La neuropathie diabetique est frequente au Niger. Sa survenue denote de la presence d'autres facteurs

Pattern of diabetic retinopathy in Kano, Nigeria

BACKGROUND:The aim of the study is to determine the pattern of retinopathy seen in diabetic patients attending the outpatient clinic in Aminu Kano Teaching Hospital, Kano, Nigeria. MATERIALS AND METHODS: Consecutive patients who were attending the diabetic clinic and who consented were examined over a three-month period. Information obtained includes patient's bio data, type and duration of disease, and findings on eye examination. The fundus was examined with direct and indirect ophthalmoscopes, +90 D with slit lamp and fundal photography. Retinopathy was graded using the International Clinical Diabetic Retinopathy Disease Severity Scale (ICDRDSS). RESULTS: A total of 214 patients were examined during the study period. There were 88 males and 126 females (M: F = 1: 1.43). The mean age of the study population was 52.14 ± 13.23 years. The mean age of patients without diabetic retinopathy (DR) was 49.14 ± 13.17 years and the mean age of patients with DR was 58.51 ± 10.94 years. Forty nine patients (23%) had insulin-dependent diabetes mellitus (IDDM) while 165 patients (77%) had non insulin dependent diabetes mellitus (NIDDM). There was statistically significant difference in presence of retinopathy in patients with IDDM compared to those with NIDDM [X(2) =29.77 {95% CI}, P=0.000]. DR was significantly more common in patients with disease duration of 15 years or more compared with those with disease duration of 14 years or less [X(2) = 65.85, {95% CI} P= 0.000]. Based on ICDRDSS scale, 136 patients (64%) had no retinopathy and 78 patients (36%) had retinopathy. Some patients were visually impaired and the cause of blindness was DR in 6 patients (2.8%). Cataract and glaucoma were the cause in 6 patients (2.8%).CONCLUSION:Diabetic retinopathy is common in our environment and is more frequent in IDDM and those with long disease duration. DR is a cause of visual disability although diabetic patients are not exempted from blindness from other eye diseases such as cataract and glaucoma. A screening program needs to be developed to facilitate early detection and prompt treatment

Management Issues in Hypertensive Diabetics

Diabetes mellitus and hypertension are common clinical conditions that often co-exist. This combination has been called the deadly duet to emphasise the increased cardiovascular risk when the two conditions co-exist. Hypertension occurs more commonly in diabetics than in comparable non-diabetics; as the prevalence of hypertension in diabetics is about two times higher than that of hypertension as observed in the general population. In type 2 diabetes mellitus; hypertension is often present as part of a possible common underlying metabolic abnormality; such as insulin resistance. However; in type 1 diabetes mellitus; hypertension is often due to the onset of diabetic nephropathy

Correlation between Retinopathy; Nephropathy and Peripheral Neuropathy among Adult Sudanese Diabetic Patients

Diabetes Mellitus is a worldwide common metabolic disorder. Increasing prevalence of diabetes; lack of proper education about the nature and course of the disease and necessary control are the main factors for an early onset of micro vascular complications. Objective: To correlate between retinopathy; nephropathy and neuropathy; among adult Sudanese diabetic patients at Elshaab Teaching hospital; Ahmed Gasim Teaching hospital and Gabber Abu Eleaz centre; from December 2006 to September 2008. were included. Result: Male to female ratio was1.4:1.Common age group affected was 60-69 (32.4).Common duration of diabetes mellitus was 20-24 years (23.9).All patients who had diabetes for 25 years or more had developed complications (19.7).The commonest long term microvascular complication was found to be retinopathy (71.2); followed by neuropathy (69) and nephropathy (50.7).It was found that (47.6) of our patients had the three complications. Conclusion: Long-term micro vascular complications affect male more than female; with average age of onset 60-69 years. All patients who had diabetes for 25 years or more had developed complications. Retinopathy is the most common micro vascular complication; followed by neuropathy. There is a significant correlation between retinopathy; nephropathy and neuropathy in association with the duration and control of blood glucose level

Relation entre pression pulsee; troubles visuels et severite de la retinopathie diabetique en Afrique sub-saharienne

Objectif: Determiner la relation entre la pression pulsee; les facteurs de risque traditionnels; les troubles visuels et la prevalence des differentes formes cliniques de la retinopathie diabetique. Materiel et methodes : Une etude transversale a ete menee entre le 1er decembre 2004 et le 16 juillet 2005 dans les centres de sante a Kinshasa. RDC. La population mere (n=3010 diabetiques) a servi a estimer la prevalence de la retinopathie diabetique tandis qu_fun echantillon representatif (n=301) a ete soumis a une approche analytique : age.20 ans; anthropometrique; composantes de la pression arterielle; glycemie a jeun; optometrie; fond d_foeil; severite de la retinopathie diabetique. Resultats : La baisse subjective etait associee a la retinopathie diabetique dans l_fechantillon (Or=2;7 IC951;1-5;4 ; p0;05) et en cas de diabete de type 2 (OR1;1-3;4 ;p0;05). La baisse subjective de l'acuite visuelle etait associee a la retinopathie diabetique dans l'echantillon (OR1;1-12;6 ;p0;05). Le risque de deficience visuelle etait plus que triple par la retinopathie diabetique chez les femmes (OR1;1-12;6 ;p0;05). Porter une grossesse apres le diagnostic de diabete multipliait par 3 le risque de retinopathie diabetique chez les femmes (OR1;1-13;2 ;p0;05). Apres regression logistique; le risque multivarie de retinopathie diabetique etait predit de facon independante par les antecedetnss familiaux de diabete sucre (OR1;2-8;8 ; p0;05); la duree du diabete . 4 annees (OR1;4-8;5 ;p0;01); la pression pulsee .60 mmHg (OR2- 12;8 ;p0;001). Conclusion : Un programme de prevention et de controle de la retinopathie diabetique et de ses facteurs de risque est souhaite pour l le benefice de l'urgence

Screening for Microalbuminuria in Newly Diagnosed Type 2 Diabetics at a Staff Clinic in Port Harcourt

Background: Most individuals working in the Nigerian National Petroleum Company (NNPC) Port Harcourt are obese (with BMI 29 kg/m2). This has been attributed to change in diet and life style. Most of these individuals present with type 2 diabetes. Individuals with diabetes are at higher risk of suffering renal damage. It is observed that in spite of the medical facilities made available to these company workers; they do not present early for management but rather present when diabetic complications have set in to worsen outcome of management. Aim: To study the prevalence of microalbuminuria (as an evidence of onset of renal complication of diabetes) in newly diagnosed type 2 diabetics and its possible relationship with other diabetic complications in this group of patients. Methods: In this prospective study; 60 newly diagnosed type 2 diabetics were tested for microalbuminuria using micral test strips. Subjects and controls were also assessed for retinopathy; hypertension and glycated haemoglobin levels. Results: Micro- albuminuria was present in 38 (63.3) patients and was found to be significantly associated with mean arterial pressure; systemic hypertension; glycated haemoglobin levels and diabetic retinopathy (p0.05). Conclusion: There is a very high rate of microalbuminuria at diagnosis of type 2 diabetes in Port Harcourt. Glycated haemoglobin level is a very good prognostic indicator for the development of microalbuminuria in this group of patients

A review of the changes in the ophthalmic and visual system in pregnancy

Pregnancy is often associated with ocular changes which may be more commonly transient but occasionally, permanent. It may be associated with the development of new ocular conditions, or can exacerbate pre-existing conditions. The ocular effects of pregnancy may be physiological or pathological or may be modifications of pre-existing conditions. Adnexial changes include chloasma, spider angiomas and ptosis. Anterior segment changes include a decrease in conjunctival capillaries and an increase in the granularity of conjunctival venules and in corneal curvature, changes in corneal thickness, refractive index, accommodation and refractive errors, and a decrease in intraocular pressure. Posterior segment changes include worsening of diabetic retinopathy, central serous chorioretinopathy, increased risk of peripheral vitreochorioretinal dystrophies and retinal detachment, and a beneficial effect on non-infectious uveitis. Systemic disorders of importance include preeclampsia, Graves disease and multiple sclerosis. Intracranial disorders with ocular effects in pregnancy include Pseudotumor cerebri, prolactinomas and Sheehan's syndrome (Afr J Reprod Health 2008; 12[3]:185-196)

Profil epidemiologique et clinique de la retinopathie chez le diabetique noir africain : a propos de 400 patients diabetiques examines nau service d'ophtalmologie du CHU de Treichville

Dans une etude transversale; exploratoire et descriptive sur une periode de 12 mois; nous avons etudie le profil epidemiologique et decri les signes de la retinopathie diabetique chez le noir africain. Notre echantillon etait constitue de 400 diabetiques et a permis de degager les caracteristiques suivantes: Au plan epidemiologique et clinique : *L'age de nos patients diabetiques variait de 12 a 87 ans avec une moyenne de 51 ans. *86 patients soit 21;5 pour cent de notre effectif avaient une retinopathie diabetique avec de facon plus specifique :*l'age des porteurs de retinopathie diabetique variait de 27 a 79 ans avec une moyenne de 55 ans; *54;65 pour cent des porteurs de retinopathie etaient de sexe masculin; *L'anciennete moyenne au bout de laquelle apparaissait la retinopathie etait de 8 ans; *56 pour cent des porteurs de retinopathie etaient des diabetiques de type 2; *34 pour cent des patients porteurs de retinopathie diabetique avaient un antecedent de diabete familial. Au plan ophtalmologique : *78 pour cent des patients porteurs de retinopathie diabetique avaient une acuite visuelle inferieure ou egale a 8/10 et 2;3 pour cent de cecite; *La cataracte apparait comme la lesion la plus observee a la lampe a fente avec 58v de l'effectif des porteurs de retinopathie diabetique; *La pression intraoculaire des porteurs de retinopathie etait comprise entre 10 et 22 mmHg avec 3;5 pour cent d'hypertonie observee dans cette serie; *Les lesions non proliferatives etaient predominantes avec 60 pour cent contre 7 pour cent de lesions proliferatives; *Les lesions decrites sont essentiellement : Le microanevrisme 4;90 pour cent; Les hemorragies : 29;44 pour cent; Les exsudats 47;85 pour cent; Les nodules cotonneux : 3;06 pour cent; Les anomalies microvasculaires intraretiniennes : 6;13 pour cent; L'ischemie retinienne : 1;22 pour cent; Les neovaisseaux 3;06 pour cent. Au plan des complications: 1;84 pour cent de decollement de retine. Nous suggerons : *La multiplication des services d'ophtalmologie et leur equipement en materiels performants pour diagnostiquer et traiter la retinopathie diabetique; *Le renforcement de la collaboration interdisciplinaire entre ophtalmologistes et diabetologues