Prevalence and associated factors of proliferative diabetic retinopathy among adult diabetic patients in Northwest Ethiopia, 2023: A cross-sectional multicenter study.

BACKGROUND: Proliferative diabetic retinopathy is one of the advanced complications of diabetic retinopathy. If left untreated, almost all eyes could lose a significant portion of their vision within four months. There is limited evidence regarding the magnitude of proliferative diabetic retinopathy and associated factors in the study setting and also in Ethiopia. PURPOSE: To determine the magnitude and associated factors of proliferative diabetic retinopathy among adult diabetic patients attending Specialized Comprehensive Hospital-Diabetic Care Clinics in Northwest Ethiopia, 2023. METHODS: A multicenter, hospital-based, cross-sectional study was conducted on 1219 adult diabetic patients selected by systematic random sampling technique. Data were collected through an in-person interview and physical examination. The Statistical Package for Social Science Version 20 was used to analyze the data. Logistic regression methods were used to test the association between predisposing factors and proliferative diabetic retinopathy. The adjusted odds ratio with a 95% confidence interval was used to determine the strength of association. RESULTS: The prevalence of proliferative diabetic retinopathy was 3.1% (95% CI: 2.10%-4.10%). Hypertension (AOR = 4.35 (95% CI: 1.87-10.12)), peripheral neuropathy (AOR = 3.87 (95% CI: 1.57-9.54)), nephropathy (AOR = 2.58 (95% CI: 1.13-5.87)), ≥10 years duration of diabetes mellitus (AOR = 5.30 (95% CI: 2.32-12.14)), insulin use (AOR = 3.07 (95% CI: 1.08-8.68)), and poor adherence to diabetes mellitus medications (AOR = 3.77 (95% CI: 1.64-8.64)) were confirmed to have statistically significant association with proliferative diabetic retinopathy. CONCLUSION: The prevalence of proliferative diabetic retinopathy among adult diabetic patients in the diabetes clinic was higher than the global study. Hypertension, peripheral neuropathy, nephropathy, ≥10 year's duration of diabetic mellitus, insulin use and poor adherence to diabetes mellitus medications were among the factors significantly associated with proliferative diabetic retinopathy.

Self-Reported Fall-Related Injury and Its Associated Factors among Adults with Visual Impairment Attending St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.

Background: Falls account for vast majority of fractures and are a significant reason for trauma related hospital admissions. The main aim of this study is to determine the prevalence of self-reported fall, related injuries, and associated factors among adult patients with visual impairment. Methods: Hospital-based cross-sectional study was conducted from July to August 2021. Systematic random sampling technique was used. The data were entered into Epi-data version 3.1 and exported to SPPS version 26 for analysis. Frequency, mean, and percentage, were used to summarize the descriptive data. The association between the outcome variable and explanatory variables was assessed using binary and multivariate logistic regressions. The adjusted odds ratio was calculated, and variables with a p-value below 0.05 at the 95% confidence interval (CI) were considered statistically significant. Result: A total of 487 study participants were involved in this study with a response rate of 93.83%. The mean age of the study participants was 52 ± 16.26 years. The overall prevalence of self-reported fall was 36.1 %. Being female, being older than 64 years of age, rural residence, fear of falling, and blind stage of visual impairment were significantly associated with falling. Conclusion: The prevalence of self-reported fall was high among visually impaired individuals. Female sex, age more than 64 years, rural residence, fear of falling, and blind stage of visual impairment were significantly associated with falling. Reducing patients' chances of suffering from falling-related injuries and consequences requires raising awareness about the burden, danger, and effects of falling on persons who are visually impaired.

Magnitude of Maladaptive Coping Strategy and Its Associated Factors Among Adult Glaucoma Patients Attending Tertiary Eye Care Center in Ethiopia.

Introduction: Coping strategy is the mechanism by which patients adjust to the condition they face. It can be adaptive or maladaptive. A maladaptive coping strategy is a harmful and ineffective way of dealing with stress or anxiety. It is common among patients with chronic illnesses. Despite Ethiopia having a greater glaucoma prevalence, there was no evidence of patients with glaucoma using maladaptive coping mechanisms. Objective: The main goal of this study was to evaluate the magnitude of maladaptive coping strategy use and the factors that associate with it among adult glaucoma patients enrolled in the Tertiary Eye Care and Training Center at the University of Gondar in Northwest Ethiopia in 2022. Methods and Materials: At the University of Gondar, Tertiary Eye Care and Training Center, a facility-based cross-sectional study was carried out on a sample of 423 glaucoma patients chosen by a systematic random sampling technique from May 15 to June 30, 2022. Optometrists conducted an interview with the study subject and reviewed the medical record, and administered a pretested, structured questionnaire of the brief cope inventory assessment. In the multivariable logistic regression, binary logistic regression was performed to identify the related factors, and significance was taken into account when the p-value was less than 0.05 at the 95% confidence interval. Results: The study found that among study participants 50.1% (95% CI: 45.1-54.5%) had a maladaptive coping strategy. Female sex (AOR=2.031, 95% CI:1.185-3.480), chronic medical illness (AOR=1.760, 95% CI:1.036-2.989), bilateral glaucoma (AOR=2.321, 95% CI: 1.328-4.055), receiving both drug and surgery treatment (AOR=1.895, 95% CI: 1.002-3.585), severe visual impairment (AOR=2.758, 95% CI:1.110-6.852), absolute glaucoma (AOR=2.543, 95% CI:1.048-6.169), duration of diagnosis >12 months (AOR=3.886, 95% CI: 2.295-6.580) were significantly associated with a maladaptive coping strategy. Conclusion and Recommendation: Half of the participants had a maladaptive coping strategy. It is better to set and plan strategies that enable the integration of coping strategy care into the current treatment of patients with glaucoma to encourage positive coping strategies instead of maladaptive ones.

Association of Poor Quality of Sleep with Vision-Threatening Diabetic Retinopathy: A Matched Case-Control Study.

INTRODUCTION: Vision-threatening diabetic retinopathy, a long-term microvascular complication of diabetes in the eye, is a major cause of blindness worldwide. Sleep is regulated by a special area of the brain, and poor quality of sleep has been implicated in long-term diabetic complications, including diabetic retinopathy. The study was aimed at exploring whether poor sleep quality is associated with the likelihood of developing vision-threatening diabetic retinopathy. METHODS: A matched case-control study was conducted from 6 May 2022 to 6 September 2022. The study was based on patients with diabetes (both type 1 and type 2), attending a retina clinic of the referral center. Patients with confirmed vision-threatening diabetic retinopathy were defined as cases and matched with control study subjects. Rating of sleep quality was done by Pittsburgh Sleep Quality Index assessment tool. Conditional logistic regression model was applied to assess the effect of overall poor sleep quality on vision-threatening diabetic retinopathy. RESULTS: The study recruited a total of 126 (63 duration-matched pairs) patients with diabetes. The overall quality of sleep was poor among 71.90% of patients in the case groups, significantly higher compared with those of the control groups (28.10%) (p < 0.00). The mean quality of sleep for cases [mean (M) = 7.10, standard deviation (SD) = 4.30] was higher than the control group (M = 3.60, SD = 2.70). The magnitude of the difference [M difference = 3.50, 95% confidence interval (CI): 2.25-4.75] was significant. Poor sleep quality predicted the chance of developing vision-threatening diabetic retinopathy in a diabetic cohort. CONCLUSIONS: This study revealed a significant association between the overall poor quality of sleep and vision-threatening diabetic retinopathy. Co-management of sleep disruption and vision-threatening diabetic retinopathy, and better sleep advisory are warranted.

Attitude Towards Traditional Eye Medicine and Associated Factors Among Adult Ophthalmic Patients Attending University of Gondar Comprehensive Specialized Hospital-Tertiary Eye Care and Training Center, Northwest Ethiopia.

BACKGROUND: Traditional eye medicine is a form of biologically based therapies, practices, or partially processed organic or inorganic agents that can be applied to the eye and lead to a blinding complication. Attitude towards those medicines plays a pertinent role in the practice of those traditional eye medicines. OBJECTIVE: To determine attitude towards traditional eye medicine and associated factors among adult ophthalmic patients attending University of Gondar Comprehensive Specialized Hospital-Tertiary Eye Care and Training Center, Northwest Ethiopia, 2020. METHODS: A hospital-based cross-sectional study was conducted on 417 newly presenting adult ophthalmic patients who were selected by using a systematic random sampling method from June 22 to August 11, 2020. The data from the interview-based structured questionnaire were entered into Epi Info 7 and analyzed by SPSS 20. Frequency and cross-tabulations were used for descriptive analysis. Association between variables was analyzed using binary logistic regression through the enter method with a 95% confidence interval. RESULTS: A total of 417 subjects with a 98.8% response rate have participated in the study. Of the total study subjects, 60.7% (253) (95% CI: 19-26%) had a positive attitude towards traditional eye medicine. Residing in a rural area (AOR=6.46 (95% CI: 2.89-14.45)), positive family history of traditional eye medicine use (AOR=8.01 (95% CI: 4.17-15.37)) and availability of traditional healer (AOR=19.43 (95% CI: 12.06-31.64)) were significantly associated with a positive attitude towards traditional eye medicine. CONCLUSION AND RECOMMENDATION: Most adult ophthalmic patients had a positive attitude towards traditional eye medicine. Residing in a rural, availability of a traditional healer, and positive family history of traditional eye medicine use had a significant positive association with a positive attitude. Educating the traditional healers on safe practices is crucial in reducing the burden.

Stereoacuity Among Patients with Refractive Error at University of Gondar, Northwest Ethiopia.

PURPOSE: This study aimed to assess the level of stereopsis, proportion of poor stereopsis, and factors influencing stereopsis in adults with refractive error. METHODS: This was a cross-sectional, descriptive study conducted on 153 adults with refractive error at Gondar University Hospital Tertiary Eye Care Center from April 08 to June 07, 2019. Structured questionnaires and ophthalmic instruments (Retinoscope, Worth Four Dot test and TNO Stereo plates) were used to collect the data. Data were entered and analyzed with Statistical Package for Social Sciences (SPSS) version 20. The result was summarized using summary statistics such as mean. Chi-squared test of association was applied between stereopsis and independent variables. RESULTS: The level of stereopsis after correction of refractive error ranged from 1.89 to 2.65 log arc second. Before correction of refractive error, poor stereopsis was observed in 46.4% of the participants, while after correction, it dropped to 39.8% (CI: 95%: 31.1%-47.8%). Stereopsis after correction had a significant association with age, best visual acuity, type of refractive error, and fusional status at distance with a p value < 0.05. CONCLUSION: Given refractive error corrected, the mean stereopsis in patients with refractive error was 2.42 log arc second. Proportion of poor stereopsis was noted in 39.8% of the participants corrected for refractive error. Age, best corrected visual acuity, type of refractive error, and fusional status had a significant association with stereopsis. Further studies on stereoacuity on a large scale are recommended.