[Diabetic retinopathy in black Africans: an angiographic study]

Diabetes mellitus is an important public health issue worldwide. This retrospective and descriptive study took place at the diabetic retinopathy (DR) prevention and management project at the Central Hospital in Yaoundé between November 2007 and December 2008. Our aim was to analyse the characteristics of diabetic retinopathy in black Africans.

Our sample included all patients with diabetes, irrespective of age or insulin- dependence, with the results of at least fasting blood sugar test and fluorescein angiography imaging. The images were interpreted according to the Early Treatment of DR Study classification by one of the 3 project ophthalmologists. We used Epi-Info version 3.5.1 for the statistical analysis, comparing results with the Chi-square test (significance set at p < 0.05).

Of 472 subjects with diabetes, 274 (58%) did not have DR, and 198 (42%, 393 eyes) did: 113 men (57%) and 85 women (43%). The mean age was 58.6 years with a mean duration of diabetes of 12.8 years. 128 subjects (64.7%) had non-proliferative DR (NPDR) in both eyes; 53 (26.8%) proliferative DR (PDR) in both eyes and 14 (7.1%) were discordant, with NPDR in one eye and PDR in the other. Macula edema was found in 21 angiographies (10.6%). In all, 6.9% of the subjects were blind.

Fluorescein angiography is an invasive complementary examination that helps to diagnose retinal pathologies, to perform laser photocoagulation, and to assess its results. It cannot, however, replaced direct or indirect funduscopy with dilated pupil. Every patient with known diabetes must systematically undergo a complete ophthalmologic exam with funduscopy and angiography to prevent the onset or control existing DR.