Prevalence and causes of visual impairment in diabetic patients in Tunisia, North Africa

Kahloun, Rim; Jelliti, Béchir; Zaouali, Sonia; Attia, S.; Yahia, Salim Ben; Resnikoff, Serge; Khairallah, Moncef

doi:10.1038/eye.2014.131

Cited by 45 publications

(52 citation statements)

References 22 publications

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“…Expectedly, we observed in this study that duration of diabetes was associated with glaucoma, cataract, diabetic retinopathy and maculopathy as it has already been pointed out in previous reports [ 3 , 4 , 16 ]. Poor blood sugar control is very frequent in African countries, leading to complications such as diabetes eye diseases [ 16 ].…”

Section: Discussionsupporting

confidence: 84%

“…Unsurprisingly, as depicted by some other authors [ 3 , 4 , 14 - 16 ], cataract, diabetic retinopathy and glaucoma were the most leading causes of visual impairment and blindness in our patients. The prevalence of cataract we observed (29.7%) is lower than that reported by Rotimi et al [ 3 ] (44.9%), Funatsu et al [ 4 ] (66.7%), Bourne et al [ 8 ] (56%), and by Oye et al [ 5 ] (62.1%).…”

Section: Discussionsupporting

confidence: 62%

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Diabetes and visual impairment in sub-Saharan Africa: evidence from Cameroon

Jingi

Nansseu

Noubiap³

et al. 2015

J Diabetes Metab Disord

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Background“Vision 2020 – the right to sight” is a program which purpose is to eliminate avoidable blindness by the year 2020 through the implementation of concrete action plans at the national and district levels. Accordingly, baseline data are needed for the planning, monitoring, follow-up and evaluation of this program. The present study aimed to better characterize visual impairment and blindness in Cameroonian diabetics by providing with baseline data on the prevalence and main causes of these affections.MethodsThis was a hospital-based cross-sectional study, conducted from October 2004 to October 2006 at the Department of Ophthalmology of the Douala General Hospital, Cameroon. We included 407 diabetic patients who were referred from diabetes clinics for ophthalmologic evaluation. Ophthalmologic data included visual acuity, intra-ocular pressure, fundoscopy and fluorescein angiography.ResultsThe prevalence of blindness and poor vision were respectively 12.3% and 17.4% with regard to the worst eyes. Fifty nine (14.5%) patients were found with diabetic maculopathy, of whom 25.4% (15/59) had poor vision, and 25.4% (15/59) were blind. The prevalence of sight threatening retinopathy (severe non-proliferative and proliferative) was 17.4%. The degree of visual impairment was comparable in both diabetic types (p = 0.825), and it increased with the severity of retinopathy (p < 0.0001), as well as that of maculopathy (p <0.0001). The prevalence of glaucoma was 15% (61/407) when considering the worst eyes. The severity of visual impairment increased with the severity of glaucoma (p = 0.001). One hundred and twenty-one (29.7%) patients presented with cataract irrespective of its location or severity. Cataract was significantly associated with poor vision and blindness (p < 0.0001). Hypertensive retinopathy (4.9%), papillary ischaemia (2.7%), vaso-occlusive eye disease (2.5%), and age-related macular edema (2%) were the other potential causes of visual impairment and blindness encountered the most in our setting. Age ≥ 50 years, male sex, duration of diabetes and hypertension variously increased the risk of having glaucoma, cataract, diabetic retinopathy or maculopathy.ConclusionPoor vision and blindness are frequent in Cameroonian diabetics, and their causes are similar to those reported by various other surveys: mainly cataract, glaucoma, diabetic retinopathy and maculopathy.

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Section: Discussionsupporting

confidence: 84%

Section: Discussionsupporting

confidence: 62%

Diabetes and visual impairment in sub-Saharan Africa: evidence from Cameroon

Jingi

Nansseu

Noubiap³

et al. 2015

J Diabetes Metab Disord

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“…Kahloun et al found that 22.2% of diabetics in Tunisia were visually impaired, 4.4% legally blind and 17.8% partially sighted. 12 Nwosu reported 18% bilateral blindness, 26% monocular blindness, 30% visual impairment in better eyes, and 20% bilateral visual impairment among DM patients in Southeast Nigeria. 11 Our findings were slightly lower than the figures reported by Nwosu.…”

Section: Discussionmentioning

confidence: 95%

<p>Profile, Visual Presentation and Burden of Retinal Diseases Seen in Ophthalmic Clinics in Sub-Saharan Africa</p>

Nkanga

Adenuga

Okonkwo

et al. 2020

OPTH

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Purpose: To determine the burden of retinal diseases and the degree of visual impairment associated with each disease, amongst Nigerians. Patients and Methods: This was a hospital-based multicenter, prospective, cross-sectional, non-comparative study conducted from January to December 2018. Data was obtained from consecutive patients with a retinal diagnosis presenting at the general ophthalmic and specialty retina clinics in four hospitals (three public, and one private teaching eye department) in Nigeria. Biodata, visual acuity and refraction, intraocular pressure, findings on dilated retinal examination, diagnosis and systemic diseases were noted. Degree of monocular and bilateral visual loss associated with each diagnosed retinal disease was summarized and p value was calculated using chi-square test. P < 0.05 was considered significant. Results: Eight hundred seventy-six of 8614 patients had a retinal diagnosis; establishing a hospital-based retinal disease prevalence of 9.8%. Male:female ratio was 1.1:1. The mean age of study patients was 49.97 (standard deviation 17.64 years). Mean symptom duration was 21.63 months (standard deviation 41.94). The mean intraocular pressure was 13.87 mmHg. Forty-three different retinal diseases were diagnosed. The most common was retinal complications of diabetes, i.e., diabetic retinopathy (DR) alone, diabetic macular edema (DME) alone and a combination of DR and DME, which accounted for 13.7%, 5.6% and 9.3%, respectively (contributed 28.6% of the entire diagnosis). This was followed by retinal detachment (RD), in 219 eyes (15.4%), dry age-related macular degeneration (AMD) in 124 eyes (8.7%). Nearly half of the eyes were blind or severely visually impaired. Blindness occurred in 34.1% of eyes; severe visual impairment in 8.2% of eyes and 29.7% had normal vision. There were 469 patients who had systemic diseases. The common systemic diseases were hypertension in 169 patients (19.3% of the total number of patients), hypertension and diabetes in 156 patients (18%), and diabetes alone in 98 patients (11.1%). Sickle cell disease was present in 1.5%. Conclusion: There is need to invest in infrastructure, local training and development of systems for early detection and treatment of several retinal diseases in sub-Saharan Africa; DR and DME having the largest burden. Collaborative physician care and management of hypertension and diabetes could significantly reduce the burden of DR and DME.

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“…(6) Diabetic complications which may adversely affect vision include: cataract, diabetic retinopathy, macular edema, intravitreal hemorrhage, tractional retinal detachment, epiretinal membranes, glaucoma, myopia and/or corneal opacity. (7) The aim of this study was to investigate the causes of severe visual impairment among Jordanian diabetics and its associated systemic factors such as hypertension, anemia, smoking, renal failure, hyperlipidemia and pregnancy.…”

Section: Introductionmentioning

confidence: 99%

Causes and Risk Factors of Visual Impairment in Type 2 Diabetes Mellitus at King Hussein Medical Center

Khatatbeh¹,

Al-Madani²,

Otoum³

2018

JRMS

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Objectives: To investigate the causes of severe visual impairment among Jordanians with type II diabetes mellitus and its associated systemic factors. . After getting the ethical approval and taking a consent form, all patients with type II diabetes mellitus who attended the medical retina clinic in the ophthalmology department and found to have best corrected visual acuity (BCVA) of less than 6/12 in the best eye were included in the study. The patients were subjected to detailed ophthalmic exam including best corrected visual acuity using Snellen chart, anterior segment exam using slit lamp bio-microscopy, intra-ocular pressure measurement using Golmann applanation tonometry and posterior segment exam using 78 and 90 diopter lens. The patients were divided into two groups; Group A where the best corrected vision in the good eye is 6/60 or worse and Group B where vision in the good eye is less than 6/12 and better than 6/60. The outcome of ocular exam in both groups was recorded and compared and the overall data were analyzed using the Excel.Results: Ninety-three patients aged between 43 and 80 years (mean 63.1± 12) were included in the study, 55% of them were males with a ratio of 1.2: 1. The duration of Diabetes Mellitus (DM) ranged between 5 and 30 years (mean 14.4± 5 years).The hemoglobin A1c (HbA1c) ranged between 6.2% and 12% (mean 8.7± 1.2). Sixty-five patient (70%) had BCVA less than 6/12 and better than 6/60 while 28 patients (30%) had BCVA of 6/60 or less. In Group A, 20 patients (70.4%) had proliferative diabetic retinopathy (PDR) while the remaining patients had non-proliferative diabetic retinopathy (NPDR). On the other hand PDR was found only in 11 patients (16.9%) in Group B, 46 patients (70.8%) in this group had NPDR and 8 patients (12.3%) had no DR. Macular edema was found in 86.2% of patients with severe visual impairment. Hypertension, hyperlipidemia, and renal failure were present in 46%, 19% and 13% of the patients, respectively, and showed statistically significant association with severe visual loss (P value <0.01). Age more than 63 years and duration of DM more than 10 years also showed significant association. Conclusion: legal blindness is frequently found among Jordanian diabetics at king Hussein Medical Centre. The most common ocular finding in patients with severe visual impairment (best corrected visual acuity is 6/60 or less) is macular edema. Hypertension, hyperlipidemia , renal failure, age more than 63 years and duration of DM more than 10 years showed statistically significant association.

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Prevalence and causes of visual impairment in diabetic patients in Tunisia, North Africa

Cited by 45 publications

References 22 publications

Diabetes and visual impairment in sub-Saharan Africa: evidence from Cameroon

Diabetes and visual impairment in sub-Saharan Africa: evidence from Cameroon

<p>Profile, Visual Presentation and Burden of Retinal Diseases Seen in Ophthalmic Clinics in Sub-Saharan Africa</p>

Causes and Risk Factors of Visual Impairment in Type 2 Diabetes Mellitus at King Hussein Medical Center

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