Five-Year Incidence and Progression of Diabetic Retinopathy in Patients with Type II Diabetes in a Tertiary Care Center in Lebanon

Carl-Joe Mehanna; Maamoun Abdul Fattah; Hani Tamim; Mona P Nasrallah; Raya Zreik; Sandra S Haddad; Jaafar El-Annan; Samih Raad; Randa S Haddad; Haytham I S Salti

doi:10.1155/2017/9805145

Five-Year Incidence and Progression of Diabetic Retinopathy in Patients with Type II Diabetes in a Tertiary Care Center in Lebanon

J Ophthalmol. 2017 May 31:2017:9805145. doi: 10.1155/2017/9805145. eCollection 2017.

Authors

Affiliations

¹ Department of Ophthalmology, American University of Beirut Medical Center, Beirut, Lebanon.
² Biostatistics Unit, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
³ Division of Endocrinology and Metabolism, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
⁴ Fouad Khoury Hospital Bikhazi Medical Group, Beirut, Lebanon.
⁵ Department of Ophthalmology, University of Texas Medical Branch, Galveston, TX, USA.
⁶ Fellow-Division of Pulmonary, Critical Care & Sleep Medicine, University of Oklahoma Health Sciences Center, USA.

Abstract

Objective: To estimate the 5-year incidence of progression rate and regression rate and risk factors for diabetic retinopathy (DR) in a cohort of Lebanese patients with type II diabetes.

Methods: We followed a cohort of 462 Lebanese patients with type II diabetes for over 5 years at the American University of Beirut Medical Center. Patients underwent yearly complete ophthalmic evaluation and fundus photographs and were assessed for the incidence, stage, and evolution of DR using modified Airlie House classification.

Results: Among the 462 patients, 281 had no DR at baseline. The 5-year cumulative incidence of any DR was 10% (95% CI: 6-13), and only baseline microalbuminuria correlated with the development of DR (OR = 10.53, 95% CI: 4.39-25.23, p < 0.0001). Among the 181 patients with baseline DR, the worsening and regression rates of DR were 31.5% (95% CI: 25-38) and 9% (95% CI: 5-13), respectively. Microalbuminuria also approached statistical significance as a risk factor for DR worsening (OR = 1.89, 95% CI: 0.97-3.70, p = 0.06).

Conclusion: The 5-year incidence of DR in this hospital-based cohort is relatively low. Microalbuminuria was independently associated with the incidence and progression of the disease. We recommend to screen patients with type II diabetes for microalbuminuria as prognostic for the development and worsening of DR.