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).

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.