Prevalence and causes of visual impairment in diabetic patients in Tunisia, North Africa

To investigate the prevalence and causes of blindness and partial sight among a population of Tunisian diabetic patients.

A cross-sectional study of 2320 randomly identified patients with diabetes mellitus. Patient's characteristics as well as data from the last ophthalmic examination were reviewed.

Of all patients examined, 60.2% were females and 39.8% were males. Mean age of patients was 54.5 years. Mean duration of diabetes was 7.6 years. Diabetic retinopathy (DR) was recorded in 26.3% of patients, and was proliferative in 3.4% of patients. The prevalence of visual impairment was 22.2%, with 4.4% patients legally blind and 17.8% partially sighted. Visual impairment was significantly associated with age ≥60 years (P<0.001), duration of diabetes >10 years (P<0.001), body mass index >25 (P=0.014), hypertension (P<0.001), heart disease (P<0.001), peripheral neuropathy (P=0.03), vegetative neuropathy (P=0.002), macroalbuminuria (P<0.001), cataract (P<0.001), DR (P<0.001), diabetic macular edema (P<0.001), open angle glaucoma (P<0.001), intravitreal hemorrhage (P<0.001), rubeosis iridis (P<0.001), neovascular glaucoma (P<0.001), and tractional retinal detachment (P<0.001).

The current report is the largest study of DR in North African region. It provides a baseline data against which future progress can be assessed. Screening and treatment can greatly reduce the incidence of visual impairment due to diabetes.