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Prevalence and risk factors for diabetic retinopathy: the Singapore Malay Eye Study.

Publication ,  Journal Article
Wong, TY; Cheung, N; Tay, WT; Wang, JJ; Aung, T; Saw, SM; Lim, SC; Tai, ES; Mitchell, P
Published in: Ophthalmology
November 2008

PURPOSE: To describe the prevalence and risk factors of diabetic retinopathy in Asian Malays. DESIGN: Population-based cross-sectional study. PARTICIPANTS: Persons with diabetes of Malay ethnicity aged 40 to 80 years in Singapore. METHODS: Diabetes mellitus was defined as random glucose of 11.1 mmol/l or more, use of diabetic medication, or a physician diagnosis of diabetes. Retinal photographs taken from both eyes were graded for diabetic retinopathy using the modified Airlie House classification system. MAIN OUTCOME MEASURES: Any diabetic retinopathy, retinopathy grades, macular edema, or vision-threatening retinopathy. RESULTS: Of the 3261 persons who participated in this study, 757 (23.1%) had diabetes and gradable retinal photographs. In persons with diabetes, the overall prevalence of any retinopathy was 35.0% (95% confidence interval [CI], 28.2-43.4), the overall prevalence of macular edema was 5.7% (95% CI, 3.2-9.9), and the overall prevalence of vision-threatening retinopathy was 9.0% (95% CI, 5.8-13.8). Compared with men, women had significantly higher proportions with more severe diabetic retinopathy, moderate (12% vs. 4%) and severe (3% vs. 0.2%) nonproliferative retinopathy, proliferative retinopathy (7% vs. 2%), and vision-threatening retinopathy (13% vs. 3%). In multiple logistic regression, independent risk factors for any retinopathy were longer diabetes duration (odds ratio [OR], 1.07; 95% CI, 1.04-1.09, per year increase), higher hemoglobin A1(c) (OR, 1.21; 95% CI, 1.10-1.33, per % increase), hypertension (OR, 1.85; 95% CI, 1.04-3.30), and higher pulse pressure (OR, 1.34, 95% CI, 1.19-1.51, per 10-mmHg increase); older age (OR, 0.73; 95% CI, 0.57-0.93, per decade increase) and higher total cholesterol levels (OR, 0.75; 95% CI, 0.63-0.89, per 1-mmol/l increase) were protective of any retinopathy. Vision-threatening retinopathy additionally was associated with previous stroke (OR, 3.74; 95% CI, 1.24-11.26), cardiovascular disease (OR, 2.23; 95% CI, 1.08-4.62), and chronic kidney disease (OR, 4.45; 95% CI, 2.18-9.07). Female gender was not an independent risk factor for diabetic retinopathy after adjusting for metabolic and socioeconomic risk factors. CONCLUSIONS: One in 10 Malay adults with diabetes in Singapore has vision-threatening diabetic retinopathy. Risk factors for retinopathy in this population are largely similar to white populations elsewhere, suggesting that control of these risk factors may reduce both the prevalence and impact of retinopathy.

Duke Scholars

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Published In

Ophthalmology

DOI

EISSN

1549-4713

Publication Date

November 2008

Volume

115

Issue

11

Start / End Page

1869 / 1875

Location

United States

Related Subject Headings

  • Singapore
  • Risk Factors
  • Prevalence
  • Photography
  • Ophthalmology & Optometry
  • Middle Aged
  • Male
  • Humans
  • Female
  • Diabetic Retinopathy
 

Citation

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Wong, T. Y., Cheung, N., Tay, W. T., Wang, J. J., Aung, T., Saw, S. M., … Mitchell, P. (2008). Prevalence and risk factors for diabetic retinopathy: the Singapore Malay Eye Study. Ophthalmology, 115(11), 1869–1875. https://doi.org/10.1016/j.ophtha.2008.05.014
Wong, Tien Y., Ning Cheung, Wan Ting Tay, Jie Jin Wang, Tin Aung, Seang Mei Saw, Su Chi Lim, E Shyong Tai, and Paul Mitchell. “Prevalence and risk factors for diabetic retinopathy: the Singapore Malay Eye Study.Ophthalmology 115, no. 11 (November 2008): 1869–75. https://doi.org/10.1016/j.ophtha.2008.05.014.
Wong TY, Cheung N, Tay WT, Wang JJ, Aung T, Saw SM, et al. Prevalence and risk factors for diabetic retinopathy: the Singapore Malay Eye Study. Ophthalmology. 2008 Nov;115(11):1869–75.
Wong, Tien Y., et al. “Prevalence and risk factors for diabetic retinopathy: the Singapore Malay Eye Study.Ophthalmology, vol. 115, no. 11, Nov. 2008, pp. 1869–75. Pubmed, doi:10.1016/j.ophtha.2008.05.014.
Wong TY, Cheung N, Tay WT, Wang JJ, Aung T, Saw SM, Lim SC, Tai ES, Mitchell P. Prevalence and risk factors for diabetic retinopathy: the Singapore Malay Eye Study. Ophthalmology. 2008 Nov;115(11):1869–1875.
Journal cover image

Published In

Ophthalmology

DOI

EISSN

1549-4713

Publication Date

November 2008

Volume

115

Issue

11

Start / End Page

1869 / 1875

Location

United States

Related Subject Headings

  • Singapore
  • Risk Factors
  • Prevalence
  • Photography
  • Ophthalmology & Optometry
  • Middle Aged
  • Male
  • Humans
  • Female
  • Diabetic Retinopathy