Epidemiology and treatment outcomes of diabetic retinopathy in a diabetic population from Cameroon

Ahmadou M Jingi,Jean Jacques N Noubiap,Augustin Ellong,Jean Joel R Bigna,Côme Ebana Mvogo

doi:10.1186/1471-2415-14-19

Abstract

BackgroundDiabetic retinopathy (DR) is the most common microvascular complication of diabetes. It can lead to significant visual loss. The aim of this study was to determine the frequency and clinical profile of diabetic retinopathy, and assess the outcomes of laser photocoagulation therapy in a diabetic population in Cameroon.MethodsWe carried out a prospective cohort study during 24 months in the Department of Ophthalmology of the Douala General Hospital, Cameroon. We included all diabetic patients who were referred from diabetes clinics for ophthalmologic evaluation. Data included type and duration of diabetes, visual acuity, intra-ocular pressure, results of fundoscopy and fluorescein angiography, and outcomes two months after treatment with laser photocoagulation.ResultsWe included 407 patients; 88% had type 2 diabetes. Their mean duration of diabetes was 6.4 years (SD=6.6). Forty point three percent (164/407) of patients were found to have DR on fundoscopy. Of the 164 patients with DR, 63.4% (104/164) had non-proliferative and 36.6% (60/164) had proliferative DR. Diabetic maculopathy was found in 14.5% (59/407) of all participants, and 36% (59/164) of patients with DR. There was a strong correlation between the duration of diabetes and retinopathy status (p < 0.001, r = 0.9541). Overall, 17.4% (71/407) of patients were eligible for laser photocoagulation. Of these, 66.2% (47/71) were treated, and 78.7% (37/47) of treated patients came back for control two months later. Among these treated patients an improvement of the retinopathy was noted in 73% (27/37), no change in 16.2% (6/37) and a worsening in 10.8% (4/37). Severe proliferative DR was significantly associated with treatment failure (p < 0.001).ConclusionsThe frequency of DR may be high among diabetic patients in Cameroon. There was a good uptake of laser photocoagulation therapy among patients affected by DR in our setting, with good treatment outcomes. Interventions to prevent diabetes and increase the precocity of diagnosis and treatment of DR should be scaled up.

Highlights

Diabetic retinopathy (DR) is the most common microvascular complication of diabetes
Diabetic maculopathy was found in 14.5% (59/407) of all participants, 18.4% (9/49) of type 1 diabetic patients and 14% (50/358) of type 2 diabetic patients; and it was found in 36% (59/164) of patients with DR
Our findings indicate that the frequency of DR may be high among diabetic patients in Cameroon

Summary

Introduction

Diabetic retinopathy (DR) is the most common microvascular complication of diabetes. It can lead to significant visual loss. The aim of this study was to determine the frequency and clinical profile of diabetic retinopathy, and assess the outcomes of laser photocoagulation therapy in a diabetic population in Cameroon. Sub-Saharan African countries are currently facing an epidemiological transition with an increasing prevalence of diabetes alongside other non-communicable diseases [2]. The prevalence of diabetes is 5.7% in urban Cameroon, with an estimated 1 million diabetic population, 70% of whom remain undiagnosed [4]. Microvascular complications of diabetes have been shown to be highly prevalent in African diabetic patients [5]. Diabetic retinopathy (DR) is the most common microvascular complication of diabetes [6]. Some previous studies have reported DR rates of about 37% in diabetics in Cameroon [7,8]

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