Diabetes Retinopathy Prevalence and Risk Factors among Diabetic Patients Seen at Highland Eye Clinic Mutare Zimbabwe: A Retrospective Study

Musokeri Tatenda Lewis, Wani Mena, Maibouge Tanko Mahamane Salissou


Objective: To determine the prevalence of diabetic retinopathy and its association with hypertension, age, gender, and fasting blood glucose level.

Methods: This retrospective study assessed the prevalence of diabetic retinopathy with its associated risk factors on 135 diabetic patients, aged 18 years and above, visiting the Highland Eye Clinic Mutare, Zimbabwe. Data were collected on the age, sex, and type of retinopathy. Based on the identified retinopathy, subjects were divided into no retinopathy, non-proliferative diabetic renopathy, and proliferative diabetic retinopathy groups. Analysis were then performed using multivariate and univariate regression analyses to test the association between the presence of retinopathy and several risk factors, and results were presented in percentages, with P< 0.05  considered to show statistical significance.

Results: The average age of the subjects this study was 60.8 ± 14 with female subjects constituted more than half of the total number of subjects (58.5%). Forty four percent were overweight (BMI 25-30), 34.8 % were obese, and the overall prevalence of diabetic retinopathy was 31.1% (non-proliferative diabetic renopathy, 20%; proliferative renopathy, 11.1%). The proportion of subjects with retinopathy increased with duration of DM, being 23.3% in those with a DM duration of less than 10 years and 46.6% in those with a DM duration of more than 10 years. Age and hypertension were significantly associated with the presence of diabetic retinopathy (P< 0.05) in univariate analysis, but no association was identified between retinopathy and fasting blood glucose (chi-square test, P =0.0965)

Conclusion: The prevalence of diabetic retinopathy (DR) is high (31.1%), Non-proliferative DR is more common than the proliferative (DR). There is a strong association between diabetic retinopathy, hypertension, and age.


Diabetes; hypertension; prevalence; retinopathy.

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  1. Banday MZ, Sameer AS, Nissar S. Pathophysiology of diabetes: an overview. Avicenna J Med. 2020;10(04):174–88.
  2. Bui HDT, Jing X, Lu R, et al. Prevalence of and factors related to microvascular complications in patients with type 2 diabetes mellitus in Tianjin, China: a cross-sectional study. Ann Transl Med. 2019;7(14):325.
  3. Wang X, Lu Y, Wang Y, Chen W-B. Diabetic retinopathy stage classification using convolutional neural networks. IEEE; 2018:465–71.
  4. Bui HDT, Jing X, Lu R, Chen J, Ngo V, Cui Z, et al. Prevalence of and factors related to microvascular complications in patients with type 2 diabetes mellitus in Tianjin, China: a cross-sectional study. Ann Transl Med. 2015;7(14):325.
  5. Teo ZL, Tham YC, Yu M, Chee ML, Rim TH, Cheung N, et al. Global Prevalence of Diabetic Retinopathy and Projection of Burden through 2045: Systematic Rev Meta-analysis. Ophthalmol. 2021;128(11):1580–91.
  6. GBD 2019 Blindness and Vision Impairment Collaborators; Vision Loss Expert Group of the Global Burden of Disease Study. Causes of blindness and vision impairment in 2020 and trends over 30 years, and prevalence of avoidable blindness in relation to VISION 2020: the Right to Sight: an analysis for the Global Burden of Disease Study [published correction appears in Lancet Glob Health. 2021 Apr;9(4):e408]. Lancet Glob Health. 2021;9(2):e144-e160.
  7. Al‐Rubeaan K, Abu El‐Asrar AM, Youssef AM, Subhani, S. N., Ahmad, N. A., Al‐Sharqawi, A. H et al. Diabetic retinopathy and its risk factors in a society with a type 2 diabetes epidemic: a Saudi National D iabetes R egistry‐based study. Acta ophthalmologica. 2015;93(2):e140–47.
  8. Elwali ES, Almobarak AO, Hassan MA, Mahmooud AA, Awadalla H, Ahmed MH. Frequency of diabetic retinopathy and associated risk factors in Khartoum, Sudan: population based study. Int J Ophthalmol. 2017;10(6):948.
  9. Machingura PI, Macheka B, Mukona M, Mateveke K, Okwanga PN, Gomo E. Prevalence and risk factors associated with retinopathy in diabetic patients at Parirenyatwa Hospital outpatients’ clinic in Harare, Zimbabwe. Archives of medical and biomedical research. 2017;3(2):104–11.
  10. Pourhoseingholi MA, Vahedi M, Rahimzadeh M. Sample size calculation in medical studies. Gastroenterol Hepatol Bed Bench. 2013;6(1):14–7.
  11. Tesfaye S, Gill G. Chronic diabetic complications in Africa. African J Diabetes Med. 2011;19(1):4–8.
  12. Deepa M, Grace M, Binukumar B, Pradeepa R, Roopa S, Khan HM, et al. High burden of prediabetes and diabetes in three large cities in South Asia: The Center for cArdio-metabolic Risk Reduction in South Asia (CARRS) Study. Diabetes Res Clin Pract. 2015;110(2):172–82.
  13. Ting DSW, Cheung GCM, Wong TY. Diabetic retinopathy: global prevalence, major risk factors, screening practices and public health challenges: a review. Clin Experimental Ophthalmol. 2016;44(4):260–77.
  14. Kirigia JM, Sambo HB, Sambo LG, Barry SP. Economic burden of diabetes mellitus in the WHO African region. BMC Int Health Hum Rights. 2009;9:6.
  15. Voigt M, Schmidt S, Lehmann T, Köhler B, Kloos, C, Voigt, U, A. et al. Prevalence and progression rate of diabetic retinopathy in type 2 diabetes patients in correlation with the duration of diabetes. Experimental Clin Endocrinol Diabetes. 2018;126(09):570–76.
  16. Cui Y, Zhang M, Zhang L, Zhang L, Kuang J, Zhang G, et al. Prevalence and risk factors for diabetic retinopathy in a cross-sectional population-based study from rural southern China: Dongguan Eye Study. BMJ Open. 2019;9(9):e023586.
  17. Scanlon PH, Aldington SJ, Stratton IM. Epidemiological issues in diabetic retinopathy. Middle East Afr J Ophthalmol. 2013;20(4):293–300.
  18. Liu L, Quang ND, Banu R, Kumar H, Tham YC, Cheng CY, et al. Hypertension, blood pressure control and diabetic retinopathy in a large population-based study. PLoS One. 2020;15(3):e0229665.
  19. Tatsumi Y, Ohkubo T. Hypertension with diabetes mellitus: significance from an epidemiological perspective for Japanese. Hypertension Research. 2017;40(9):795–806.
  20. Walraven I, Mast MR, Hoekstra T, Jansen AP, Rauh SP, Rutters FR, et al. Real-world evidence of suboptimal blood pressure control in patients with type 2 diabetes. J Hypertension. 2015;33(10):2091–8.
  21. Raum P, Lamparter J, Ponto KA, Peto, T, Hoehn R, Schulz A, et al. Prevalence and cardiovascular associations of diabetic retinopathy and maculopathy: results from the Gutenberg Health Study. PloS one. 2015;10(6):e0127188.
  22. Bansal P, Gupta RP, Kotecha M. Frequency of diabetic retinopathy in patients with diabetes mellitus and its correlation with duration of diabetes mellitus. Med J Dr DY Patil University. 2013;6(4):366.
  23. Ahsan H. Diabetic retinopathy–biomolecules and multiple pathophysiology. Diabetes Metabolic Syndrome: Clin Res Rev. 2015;9(1):51–4.
  24. Matsushita Y, Takeda N, Nakamura Y, Yoshida-Hata N, Yamamoto S, Noda M, et al. Comparison of the association of fasting plasma glucose and HbA1c levels with diabetic retinopathy in Japanese Men. J Diabetes Res. 2020;2020:3214676.
  25. Atchison E, Barkmeier A. The role of systemic risk factors in diabetic retinopathy. Current ophthalmology reports. 2016;4(2):84–9.
  26. Zhou Y, Zhang Y, Shi K, Wang C. Body mass index and risk of diabetic retinopathy: A meta-analysis and systematic review. Medicine (Baltimore). 2017;96(22):e6754.
  27. Cekić S, Cvetković T, Jovanović I, Jovanović, P., Pešić, M., Babić, G. S.et al. C-reactive protein and chitinase 3-like protein 1 as biomarkers of spatial redistribution of retinal blood vessels on digital retinal photography in patients with diabetic retinopathy. Bosnian J Basic Med Sci. 2014;14(3):177.

DOI: https://doi.org/10.15850/ijihs.v10n2.2697

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