Research article

Prevalence of diabetic retinopathy in Tehran province: a population-based study

Mohammad Ali Javadi¹ , Marzieh Katibeh¹ , Nasrin Rafati¹ , Mohammad Hossein Dehghan¹ , Farid Zayeri² , Mehdi Yaseri³ , Mojtaba Sehat³ and Hamid Ahmadieh¹

¹Ophthalmic Research Center, Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran

²Department of Biostatistics, Faculty of Paramedical sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran

³Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran

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BMC Ophthalmology 2009, 9:12doi:10.1186/1471-2415-9-12

Published:	16 October 2009

Abstract

Background

To determine the prevalence and characteristics of diabetic retinopathy (DR) among Iranian patients with diabetes.

Methods

Design: population-based cross-sectional study.

Participants: patients with diabetes aged 25 to 64 years in Tehran province, Iran. This survey was conducted from April to October 2007. The study sample was derived from the first national survey of risk factors for non-communicable disease. Diabetes mellitus was defined as a fasting plasma glucose of ≥ 7.0 mmol/l (126 mg/dl) or more, use of diabetic medications, or a physician's diagnosis of diabetes. All patients known to have diabetes underwent an eye examination by bio-microscope and indirect ophthalmoscope to check for any signs of DR through dilated pupils by + 78 lens. Participants were also interviewed and examined to determine their demographic characteristics, medical conditions and the regularity of their eye visits.

Results

Among 7989 screened patients, 759 (9.5%) had diabetes. Of them, 639 patients (84.2%) underwent eye examination. Five patients (0.7%) with media opacity were excluded. Of 634 examined patients with diabetes, 240 had some degree of diabetic retinopathy, and the overall standardized prevalence of any retinopathy was 37.0% (95% CI: 33.2-40.8), including 27.3% (95% CI: 23.7-30.8) (n = 175) with non-proliferative and 9.6% (95% CI: 7.3-11.9) (n = 65) with proliferative diabetic retinopathy. Clinically significant macular edema and vision-threatening retinopathy were detected in 5.8% (95% CI: 4.0-7.7) (n = 38) and 14.0% (95% CI: 11.3-16.7) (n = 95) of patients, respectively. Only 143 patients (22.6%) with diabetes had a history of regular eye examination.

Conclusion

This study demonstrated a high prevalence and poor control of DR in Tehran province. This suggests the need for adequate prevention and treatment in patients with diabetes.