Purpose:
To study the prevalence of cataract, including sub-types, in a population-based study in Type II diabetes mellitus and elucidate the risk factors associated with it.
Methods:
Of the 5999 subjects enumerated, 1414 individuals with diabetes were identified; of these 1414, 131 were excluded due to bilateral cataract surgeries (n=125), and six, ungradable images (n=6). Severity of lens opacities was graded according to photographic standards, using LOCS III standard photographs.
Results:
Age - and gender adjusted prevalence of cataract was 65.7% (95%CI: 65.6-65.8). The most common sub-type was the mixed cataract: combination of nuclear sclerosis (NC), cortical cataract (CC), and posterior subcapsular cataract (PSC) (Figure 1). For presence of cataract in type II diabetes mellitus, on multivariate analysis, increasing age [OR 1.14 , 95%CI(1.12-1.17)], macroalbuminuria [OR 4.89, 95% CI (1.65-14.45)] and increasing glycosylated hemoglobin [OR 1.79, 95%CI (1.15-2.79)] were identified as risk factors, and higher hemoglobin [OR 0.39, 95%CI (0.23-0.66)], as the protective factor.For sub-types, increasing serum triglyceride [OR 6.83, 95%CI(1.22-38.18)] was associated with nuclear cataract, female gender [OR 9.12 , 95%CI(1.09-76.14)] with posterior subcapsular, employment status with PSC [OR 9.80, 95%CI (1.14-84.07)] and NC+CC+PSC[OR 2.56, 95%CI(1.07-6.10)], Lower socioeconomic status [OR 2.39, 95%CI(1.04-5.47)] with CC+PSC; higher education [OR 0.04, 95%CI(0.00-0.46)] was protective for NC+CC.
Conclusions:
Around two-thirds of the population with diabetes mellitus showed evidence of cataract, the commonest being the mixed variety.
Keywords: cataract • diabetes • clinical (human) or epidemiologic studies: prevalence/incidence