Diabetic Retinopathy in Tunisia

Abstract

Purpose: : This study aimed to determine the prevalence and characteristics of diabetic retinopathy (DR) in Tunisia.

Methods: : A total of 1155 persons, aged between 12 and 90 years, with definite diabetes mellitus, underwent a complete ophthalmic examination including detailed medical history, stereoscopic fundus photography, and fluorescein angiography. Photographs were graded in a masked manner to assess the presence and severity of DR.

Results: : Diabetic retinopathy was detected in 244 patients (21.1%), with mild or moderate nonproliferative DR in 62 patients (5.4%), severe nonproliferative DR in 46 patients (4%), and proliferative DR in 18 patients (1.5%). Macular edema was observed in 6.1% and clinically significant macular edema was observed in 4% of all diabetics. Women had significantly higher rate of retinopathy (11.9%) than men (9.3%) (p=0.01). Furthermore, DR was significantly associated with age (p<0.001), longer duration of diabetes (p<0.001) and insulin–dependent diabetes mellitus (p<0.001). No significant association was found between the presence of DR and hypertension (p=0.39), nephropathy (p=0.80) or blood lipids (p=0.56).

Conclusions: : Our data suggest that the prevalence of DR is high in Tunisia. Age, gender, longer duration of diabetes and insulin treatment were associated with a significantly increased prevalence of DR. Further studies on incidence and progression are required to better understand the natural history of DR in this population.

Keywords: diabetic retinopathy • diabetes • retina