Prevalence of Diabetic Retinopathy and Blindness in Indonesian Adults With Type 2 Diabetes

Am J Ophthalmol. 2017 Sep:181:79-87. doi: 10.1016/j.ajo.2017.06.019. Epub 2017 Jun 30.

Abstract

Purpose: To report the prevalence of diabetic retinopathy (DR) and DR-related blindness in an Indonesian population with type 2 diabetes.

Methods: Design: Population-based cross-sectional study.

Setting: Community health centers.

Study population: We recruited 1184 people aged older than 30 years with type 2 diabetes residing in Jogjakarta, Indonesia. Multistage, clustered random sampling based on regencies and districts in Jogjakarta was used.

Observation procedure: Detailed interviews, general and eye examinations, and anthropometric measurement were performed. Disc- and macula-centered retinal photographs were taken to assess DR. The definition of DR followed a modified Airlie House classification system and was categorized into mild, moderate, and vision-threatening DR (VTDR).

Main outcome measure(s): Prevalence and severity of DR.

Results: The median (range) age and diabetes duration of participants was 59 (52-65) and 4 (2-9) years. The prevalence of DR was 43.1% (95% confidence interval 39.6%-46.6%), with mild, moderate, and severe NPDR and PDR to be 9.41%, 7.46%, 11.1%, and 12.1%, respectively. The prevalence of VTDR was 26.3% (23.1%-29.5%). Longer diabetes duration, higher fasting glucose, presence of hypertension, and foot ulcers were associated with DR and VTDR. The prevalence of bilateral blindness was 4% and 7.7% in persons with DR and VTDR.

Conclusions: This study reports a high prevalence of any DR and VTDR among Indonesian adults with type 2 diabetes in urban and rural areas: approximately 1 in 4 adults with diabetes had VTDR and 1 in 12 of those with VTDR was bilaterally blind, suggesting the need for appropriate screening and management of DR among the Indonesian population.

MeSH terms

  • Aged
  • Blindness / diagnosis
  • Blindness / epidemiology*
  • Blood Glucose / metabolism
  • Blood Pressure
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 2 / diagnosis
  • Diabetes Mellitus, Type 2 / epidemiology*
  • Diabetic Retinopathy / diagnosis
  • Diabetic Retinopathy / epidemiology*
  • Female
  • Humans
  • Indonesia / epidemiology
  • Male
  • Middle Aged
  • Population Groups
  • Prevalence
  • Risk Factors
  • Rural Population / statistics & numerical data
  • Surveys and Questionnaires
  • Urban Population / statistics & numerical data

Substances

  • Blood Glucose