Population based assessment of diabetic retinopathy in an urban populationin southern India

Aim-To assess the prevalence of diabetic retinopathy and the visual impairm ent caused by it in an urban population in southern India in order to deter mine its public health significance. Methods-2522 subjects (85.4% of those eligible), a representative sample of the population of Hyderabad city in southern India, underwent interview an d detailed dilated eye examination during 1996-7 as part of the Andhra Prad esh Eye Disease Study. Results-124 subjects, all greater than or equal to 30 years old, reported t hat they had diabetes, an age-sex adjusted prevalence of 7.82% (95% confide nce interval (CI) 5.76-9.88%) in this age group. Diabetes was diagnosed at age greater than or equal to 30 years in all but two subjects. The duration since diagnosis of diabetes was <10 years in 75.6% and greater than or equ al to 15 years in 6.7%. Diabetic retinopathy was present in 28 subjects, 1. 78% (95% CI 1.09-2.48%) of those greater than or equal to 30 years old. Mos t of the diabetic retinopathy was of the mild (50%) or moderate (39.3%) non -proliferative type; one subject (3.6%) had proliferative retinopathy. Mult iple logistic regression revealed that the odds of having diabetic retinopa thy were significantly higher in those greater than or equal to 50 years th an in those 30-49 years old (odds ratio 7.78, 95% CI 2.92-20.73). Three sub jects had visual impairment between 6/12 and 6/38 in either eye due to diab etic retinopathy, 0.19% (95% CI 0-0.41%) of those greater than or equal to 30 years old. Conclusion-Visual impairment due to diabetic retinopathy was relatively unc ommon in this urban Indian population in 1996-7, However, this could change in the near future with an increase in duration of diabetes because of the anticipated aging of India's population and the recent suggestion of incre ase in diabetes prevalence in urban India, and therefore should be monitore d.