Regional variation in diabetic retinopathy and associated factors in Spectrum of Eye Disease in Diabetes (SPEED) study in India-Report 5

• Published in: Indian journal of ophthalmology 2021-11, Vol.69 (11), p.3095-3101
• Main Authors: Das, Taraprasad, Murthy, Gudlavalleti V S, Pant, Hira B, Gilbert, Clare, Rajalakshmi, Ramachandran, Behera, Umesh C
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Cross-Sectional Studies; Diabetes; Diabetes mellitus (non-insulin dependent); Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - epidemiology; Diabetic retinopathy; Diabetic Retinopathy - diagnosis; Diabetic Retinopathy - epidemiology; Edema; Eye diseases; Humans; India - epidemiology; Macular Edema; Male; Middle Aged; Original; Population studies; Prevalence; Retinopathy; Risk Factors; Variation
• ISSN: 0301-4738; 1998-3689
• DOI: 10.4103/ijo.IJO_3620_20

To study the zonal variations in diabetic retinopathy (DR) and associated factors in people with known type 2 diabetes mellitus (T2DM) attending large eye care facilities in different regions of India. In this cross-sectional eye-care facility-based study, India was divided into five zones; large eye care facilities with a good referral base and offering an entire range of care for patients with DR were invited. First-time T2DM attendees aged ≥18 years were recruited. All subjects received a comprehensive systemic and ophthalmic examination. DR and systemic diseases were classified as per the international/national standards. Findings were compared between the zones and with the national average. Fourteen eye-care facilities (15% public) from five zones participated. In the cohort of 11,173 people, there were more males (59%); the average age was above 45 years, and in 57%, DM had been diagnosed more than 5 years earlier. Compared with the overall study population, the proportion of people with any DR, sight-threatening DR, and blind were higher in the east zone (42.5%, 95% confidence interval [CI]: 40.2-44.8; 24.3%, 95% CI 22.3-26.3, and 11.5%, respectively); diabetic macular edema was more frequent in the south zone (12.2%, 95% CI 11.2-13.2); people with moderate-to-severe visual impairment were more in the west zone (32.1%) and higher proportion of people in the south-central zone had systemic hypertension (56.8%, 95% CI 54.8-58.9). The zonal variation in DR and related vision loss could be related to variable health-seeking behavior, availability, and confidence in the available services.