Guangming Jin1, Wei Xiao1, Xiaohu Ding1, Xiao Xu2, Lei An2, Nathan Congdon1,3,4, Jialiang Zhao5, Mingguang He1,6. 1. State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China. 2. Rehabilitation Administration Department, National Institute of Hospital Administration, Chinese National Health and Family Planning Commission, Beijing, China. 3. Translational Research for Equitable Eye Care, Centre for Public Health, Royal Victoria Hospital, Queen's University Belfast, Belfast, United Kingdom. 4. Orbis International, New York, New York, United States. 5. Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, Beijing, China. 6. Centre for Eye Research Australia, Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, Australia.
Abstract
Purpose: To investigate the prevalence and determinants of diabetic retinopathy (DR) among older adults in rural Southern China. Methods: Using random cluster sampling, persons aged 50 years or older were randomly selected in rural Yangxi County, Guangdong Province, China. All participants underwent a standardized interview, fundus photography, and point of service glycosylated hemoglobin A1c (HbA1c) testing. Diabetes mellitus (DM) was diagnosed based on confirmed medical history or HbA1c ≥6.5%. Fundus photographs were graded for DR and diabetic macular edema (DME) based on the United Kingdom National Diabetic Eye Screening Program guidelines. Prevalence of and risk factors for DR and vision-threatening diabetic retinopathy (VTDR) were evaluated. Results: Among 5825 subjects who participated (90.7% response rate) in the Yangxi Eye Study, 562 (9.6%) were diagnosed with DM, including 79 (14.1%) known and 483 new (85.9%) cases. Among DM cases, 476 (84.7%) had gradable fundus photos. The prevalence of any DR and VTDR were 8.19% (95% confidence interval [CI] 5.9-11.0) and 5.25% (95% CI 3.43-7.66), respectively. These figures were 23.9% and 12.7% for known and 5.43% and 3.95% for new DM cases. Risk factors for any DR were higher HbA1c level (OR [odds ratio] per unit 1.34, P < 0.001), longer duration of DM (OR per year = 2.29, P < 0.001) and having previously undergone cataract surgery (OR 4.11, P < 0.030). Conclusions: Our study found a lower prevalence of DR among adults 50 years and older than in previously reports. Perhaps this difference can be explained by the short duration of most cases.
Purpose: To investigate the prevalence and determinants of diabetic retinopathy (DR) among older adults in rural Southern China. Methods: Using random cluster sampling, persons aged 50 years or older were randomly selected in rural Yangxi County, Guangdong Province, China. All participants underwent a standardized interview, fundus photography, and point of service glycosylated hemoglobin A1c (HbA1c) testing. Diabetes mellitus (DM) was diagnosed based on confirmed medical history or HbA1c ≥6.5%. Fundus photographs were graded for DR and diabetic macular edema (DME) based on the United Kingdom National Diabetic Eye Screening Program guidelines. Prevalence of and risk factors for DR and vision-threatening diabetic retinopathy (VTDR) were evaluated. Results: Among 5825 subjects who participated (90.7% response rate) in the Yangxi Eye Study, 562 (9.6%) were diagnosed with DM, including 79 (14.1%) known and 483 new (85.9%) cases. Among DM cases, 476 (84.7%) had gradable fundus photos. The prevalence of any DR and VTDR were 8.19% (95% confidence interval [CI] 5.9-11.0) and 5.25% (95% CI 3.43-7.66), respectively. These figures were 23.9% and 12.7% for known and 5.43% and 3.95% for new DM cases. Risk factors for any DR were higher HbA1c level (OR [odds ratio] per unit 1.34, P < 0.001), longer duration of DM (OR per year = 2.29, P < 0.001) and having previously undergone cataract surgery (OR 4.11, P < 0.030). Conclusions: Our study found a lower prevalence of DR among adults 50 years and older than in previously reports. Perhaps this difference can be explained by the short duration of most cases.