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)

Abstract

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.

Risk factors for visual impairment and blindness amongst black adult diabetis receiving treatment at Government healthcare facilitis in Mopani District, Limpopo province, South Africa

“…This may be attributed to the fact that most of the participants in this study were obese. This finding is in agreement with those of other studies 11 , 14 which did not find any significant association.…”

“…The positive association of increasing age with VI and blindness found in this study is in agreement with findings from several previous studies. 12 , 13 , 14 , 15 , 32 , 33 The probable explanation for the association is that many blinding eye diseases, such as cataract, glaucoma and DR, are age-related. The fact that a larger percentage of the participants were ≥ 60 years of age may explain the association between age and VI and blindness in this study.…”

“…This agrees with the findings of a previous study 9 that low income earners in the general population were twice as likely to have VI as those with higher income. Low socio-economic status 14 has also been reported to be significantly associated with increased risk of VI. However, findings in this study disagree with those of another study 32 where no association was reported.…”

“…Several demographic and socio-economic risk factors have been reported to be significantly associated with VI and blindness in the general population, including age, 9 gender, 9 educational and economic status. 8 , 9 Sociodemographic profiles such as age, 11 , 12 , 13 , 14 female gender, 12 , 14 low level of education, 8 , 15 unemployment 12 and low income 9 have been reported to be positively associated with VI and blindness amongst DM patients. Further, types of DM, 16 , 17 , 18 insulin treatment 12 , 14 and hypertension 13 , 14 have been found to be positively associated with VI and blindness.…”

Age-Related Macular Degeneration Is Associated with Less Physical Activity among US Adults: Cross-Sectional Study

“…Vision loss associated with AMD may also negatively influence other aspects of an individual’s health, as recent work demonstrates that those with vision impairment engage in less moderate-to-vigorous physical activity (MVPA) than those without vision impairment [ 10 ]. This is concerning, as insufficient participation in physical activity may increase the risk of developing metabolic, cardiovascular, and cerebrovascular diseases [ 11 ] that are associated with vision loss, systemic illness, and premature mortality [ 12 , 13 ].…”