[Diabetic retinopathy in Dakar and review of African literature: epidemiologic elements]

Literature review shows that in the African Sub-Sahara, prevalence of diabetic retinopathy is between 15 and 52%, the main age being the fifties (between 45.5 and 53.25 years in our cases); after 5 years of diabetes evolution (8.45 +/- 6.93 years in our cases) men being two to three fold more affected than women; non insulin dependent diabetes representing 77% and insulin dependent diabetes 23%. The type of retinopathy is usually mixed, both edematous and ischemic (88% being non proliferative). Retinopathy concerned mainly non obese, non insulin dependent diabetics in our cases. Risk factors are poor glycemic control and arterial hypertension. Diabetes duration was the sole and most evident risk factor. Diabetes duration was 5.28 +/- 5.28 years when retina was normal and reached 8.58 +/- 5.33 years for Stage II and 12.8 +/- 6.31 years for retinopathy Stage III and 16.75 +/- 7.25 years for retinopathy Stage IV. These factors, delayed diagnosis and diabetes progression in Africa justify improvement of diabetes care by multidisciplinary team to prevent blindness.