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Middle East African Journal of Ophthalmology Middle East African Journal of Ophthalmology
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ORIGINAL ARTICLE
Year : 2012  |  Volume : 19  |  Issue : 1  |  Page : 129-134

Prevalence of visual impairment and associated risk factors in subjects with type II diabetes mellitus: Sankara Nethralaya diabetic retinopathy epidemiology and molecular genetics study (SN-DREAMS, report 16)


1 Shri Bhagwan Mahavir Vitreoretinal Services, 18 College Road, Sankara Nethralaya, Chennai, Tamil Nadu, India
2 Elite School of Optometry, No. 8, G.S.T. Road, St. Thomas Mount, Chennai, Tamil Nadu, India
3 Department of Preventive Ophthalmology, 18 College Road, Sankara Nethralaya, Chennai, Tamil Nadu, India

Correspondence Address:
Tarun Sharma
Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, 18 College Road, Chennai - 600006, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0974-9233.92129

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Purpose: To report the prevalence of visual impairment (VI) and the associated risk factors in type II diabetic subjects. Materials and Methods: The study included type II diabetes mellitus subjects who were enrolled from a cross-sectional study. Participants underwent biochemical testing and comprehensive ocular examination including stereo fundus photography. The VI was defined based on the World Health Organization criteria. Results: The prevalence of VI was 4% in the cohort. The risk factors associated with the presence of VI included a female gender, age greater than 60 years, low socio-economic status, hypertension, microalbuminuria, macroalbuminuria, neuropathy, use of insulin and alcohol. Various ocular risk factors are nuclear sclerosis, subjects who have undergone cataract surgery, myopia and sight-threatening diabetic retinopathy (STDR). After adjusting for the factors using stepwise logistic regression analysis, hypertension, use of alcohol, post-cataract surgery and myopia were not risk factors. Stepwise logistic regression analysis indicated that VI was higher among subjects older than 60 years (odds ratio (OR): 4.95 [2.67-9.15]) and those who belonged to a low socio-economic status (OR: 2.91 [1.24-6.85]). The systemic risk factors for VI included microalbuminuria (OR: 2.91 [1.59-5.33]), macroalbuminuria (OR: 4.65 [1.57-13.77]) and presence of neuropathy (OR: 1.97 [1.09-3.59]) among subjects. Subjects with nuclear sclerosis (OR: 36.82 [11.12-112.36]) and presence of STDR (OR: 4.17 [1.54-11.29]) were at a higher risk of VI. Cataract was the most common cause of VI in the cohort. Conclusion: Visual impairment, among type II diabetic subjects (4%), is a major public health problem that needs to be addressed. Cataract is the most common reversible cause of vision impairment in this population.


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