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Prevalence of refractive errors and associated risk factors in subjects with type 2 diabetes mellitus SN-DREAMS,
Padmaja Kumari Rani1, Rajiv Raman, Sudhir R Rachapalli
1Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, Chennai, Tamil Nadu, India.
Purpose:
To report the prevalence of refractive errors and the associated risk factors in subjects with type 2 diabetes mellitus from an urban Indian population.
Design:
Population-based, cross-sectional study.
Participants:
One thousand eighty participants selected from a pool of 1414 subjects with diabetes.
Methods:
A population-based sample of 1414 persons (age >40 years) with diabetes (identified as per the World Health Organization criteria) underwent a comprehensive eye examination, including objective and subjective refractions.
Main Outcome Measures:
One thousand eighty subjects who were phakic in the right eye with best corrected visual acuity of > or =20/40 were included in the analysis for prevalence of refractive errors. Univariate and multivariate analyses were done to find out the independent risk factors associated with the refractive errors.
Results:
The mean refraction was +0.20+/-1.72, and the Median, +0.25 diopters. The prevalence of emmetropia (spherical equivalent [SE], -0.50 to +0.50 diopter sphere [DS]) was 39.26%. The prevalence of myopia (SE <-0.50 DS), high myopia (SE <-5.00 DS), hyperopia (SE >+0.50 DS), and astigmatism (SE <-0.50 cyl) was 19.4%, 1.6%, 39.7%, and 47.4%, respectively. The advancing age was an important risk factor for the three refractive errors: for myopia, odds ratio (OR; 95% confidence interval [CI] 4.06 [1.74-9.50]; for hyperopia, OR [95% CI] 5.85 [2.56-13.39]; and for astigmatism, OR [95% CI] 2.51 [1.34-4.71]). Poor glycemic control was associated with myopia (OR [95% CI] 4.15 [1.44-11.92]) and astigmatism (OR [95% CI] 2.01 [1.04-3.88]). Female gender was associated with hyperopia alone) OR [95% CI] 2.00 [1.42-2.82].
Conclusions:
The present population-based study from urban India noted a high prevalence of refractive errors (60%) among diabetic subjects >40 years old; the prevalence of astigmatism (47%) was higher than hyperopia (40%) or myopia (20%).
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