Predictors of proliferative diabetic retinopathy among patients with type 2 diabetes mellitus in Malaysia as detected by fundus photography

Abstract

Abstract Objectives Diabetic eye disease is the most common cause of visual loss in adults, and proliferative diabetic retinopathy (PDR) is the main cause of blindness. This study aimed to determine the predisposing factors for PDR that were identified by fundus photography among patients with type 2 diabetes mellitus (DM) at the Diabetic Clinic at Hospital Universiti Sains Malaysia. Methods In this retrospective study, fundus photo review was performed on patients with type 2 DM who had undergone diabetic retinopathy screening using a non-mydriatic fundus camera from January 2008 until December 2012. Fundus photos were classified into 2 groups, PDR and no apparent diabetic retinopathy (no DR). Socio-demographic data and clinical and metabolic profiles were obtained from the medical records. Logistic regression was used to determine the factors associated with PDR. Results A total of 120 patients were selected, with 30 patients in the PDR group and 90 patients in the no DR group. The mean age of patients with PDR was 52 (7.94) years and was 58 (12.31) years in the no DR group. Hypertension and hyperlipidaemia were the most common comorbidities identified in this study. The HbA1c level >6.5% and LDL level >2.6 mmol/L were higher in the PDR group. Age ( p = 0.032), duration of DM ( p = 0.022), nephropathy ( p = 0.002) and peripheral neuropathy ( p = 0.001) were significantly associated with PDR. Conclusion The significant predictors of PDR among patients with type 2 DM as detected by fundus photography were age, duration of DM, nephropathy and peripheral neuropathy.