RESUMO
To determine the frequency of diabetic retinopathy among indoor diabetic patients. To document the effect of duration, type, control of diabetes, gender and concurrent hypertension on severity of retinopathy in our local population. Detailed ophthalmic evaluation of indoor diabetic patients in Pakistan Railways Hospital Rawalpindi was performed. History of duration, type of diabetes, control, treatment and hypertension was recorded. Thorough ophthalmic examination was performed including fundus evaluation with maximum mydriasis using direct and indirect ophthalmoscopy and superfield lens fundus assessment under high magnification. Out of 4725 patients admitted, 789 were diabetics. 171 diabetics presented to ophthalmology department. Non-proliferative diabetic retinopathy [NPDR] was seen in 25.14% and proliferative diabetic retinopathy [PDR] in 11.11% of cases. Advanced diabetic eye disease was seen in 3.8% of patients [included in PDR cases]. Retinopathy was more frequent in cases with longer duration, type 1 diabetes, poor control, male gender and concurrent hypertension [with poor diabetic control]. Hypertension in the presence of good diabetic control did not adversely affect the retinopathy. On comparing the presence and severity of retinopathy between 10 years duration of diabetes, a statistically significant difference was found [p 0.0005]. Comparing the same between type 1 and type 2 diabetes, the difference was statistically significant [p 0.006] while comparison between good and poor control of diabetes yielded a difference that was statistically significant [p 0.0495]. Gender comparison revealed male preponderance but the difference was not statistically significant [p 0.739]. Among the diabetic admissions seen, 36.25% of patients had the changes of diabetic retinopathy. Significantly greater frequency of retinopathy was seen in cases with longer duration, type 1 and poor control of diabetes. Hypertension in the presence of poorly controlled diabetes affected the retinopathy adversely. Developing countries require aggressive screening and control strategies for diabetes to prevent microvascular complications