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

To report the prevalence of visual impairment [VI] and the associated risk factors in type II diabetic subjects. 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. 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. 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