Prevalence and Demographic Patterns of Diabetic Retinopathy, Retinal Vein Occlusion, and Age-Related Macular Degeneration in Eastern India: An Epidemiological Study
Article Sidebar
Main Article Content
Abstract
Purpose: To elucidate the epidemiology, clinical characteristics, and treatment outcomes of retinal diseases in Eastern India.
Methodology: This prospective observational study was conducted at a tertiary care hospital from August 2021 to December 2022. Adult patients (≥18 years) diagnosed with diabetic retinopathy (DR), retinal vein occlusion (RVO), or age-related macular degeneration (ARMD) were enrolled after obtaining informed consent. Comprehensive data collection, including demographic information, clinical characteristics, and treatment outcomes, was conducted. Data were analyzed using descriptive and inferential statistical methods.
Results: The study cohort (N=812) exhibited a predominance of DR (60.84%, 95% CI: 57.4-64.2%), followed by branch retinal vein occlusion (BRVO, 18.72%, 95% CI: 16.1-21.6%), ARMD (12.07%, 95% CI: 10.0-14.5%), and central retinal vein occlusion (CRVO, 11.08%, 95% CI: 9.1-13.4%). Demographic analysis revealed a male predominance (73.65%, 95% CI: 70.5-76.6%) and a younger population (60.3% ≤60 years, 95% CI: 56.9-63.6%). Comorbidities were highly prevalent, with diabetes mellitus (69.83%, 95% CI: 66.6-72.9%) and hypertension (58.99%, 95% CI: 55.6-62.3%) being the most common. Clinical evaluation showed decreased vision as the primary symptom (97.17%, 95% CI: 95.8-98.1%). Best Corrected Visual Acuity (BCVA) of 0.5 or better was observed in 52.1% of patients (95% CI: 48.7-55.5%). Optical Coherence Tomography revealed Central Macular Thickness exceeding 300 µm in 34.62% of cases (95% CI: 31.4-37.9%). Laser therapy was the predominant treatment modality (11.13%, 95% CI: 9.2-13.4%). Follow-up adherence demonstrated a significant decline after the initial visit (from 76.13% to 16.77%, p<0.001).
Conclusion: This study highlights the urgent need for enhanced screening protocols and multidisciplinary management strategies in Eastern India to address the high burden of retinal diseases. Targeted interventions in this region could prevent vision loss and improve healthcare outcomes.
Keywords
Retinal Diseases, Eastern Part of India, Management, comorbid diseases
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
References
2. Solomon SD, Chew E, Duh EJ, et al. Diabetic retinopathy: a position statement by the American Diabetes Association. Diabetes Care. 2017;40(3):412-418.
3. Scott IU, Campochiaro PA, Newman NJ, Biousse V. Retinal vascular occlusions. Lancet. 2020;396(10266):1927-1940.
4. Kazantzis D, Theodossiadis G, Machairoudia G, Dimitriou E, Theodossiadis P, Kroupis C, Chatziralli I. Risk factors for retinal vein occlusion: Multivariate approach in a case-control study. AJO International. 2024;1:100006.
5. Mitchell P, Liew G, Gopinath B, Wong TY. Age-related macular degeneration. Lancet. 2018;392(10153):1147-1159.
6. International Diabetes Federation. IDF Diabetes Atlas, 10th edn. Brussels,
Belgium: 2021. Available at: https://www.diabetesatlas.org
7. Jonas JB, Nangia V, Khare A, Sinha A, Lambat S. Prevalence and associations of retinal vein occlusions: the Central India Eye and Medical Study. Retina. 2013;33(1):152-159.
8. Sivaprasad S, Silva P, Garcia-Arumí J. Age-related macular degeneration: current treatments and future options. Br J Ophthalmol. 2015;99(2):142-147.
9. Zhu Z, Shang X, Wang W, et al. Impact of Retinopathy and Systemic Vascular Comorbidities on All-Cause Mortality. Front Endocrinol (Lausanne). 2021;12:750017.
10. Everett LA, Paulus YM. Laser Therapy in the Treatment of Diabetic Retinopathy and Diabetic Macular Edema. Curr Diab Rep. 2021;21(9):35. Published 2021 Sep 6.
11. Bhandari S, Poudel M, Paudyal I, et al. Treatment outcomes of retinal vein occlusion in clinical practice in Nepal. BMC Ophthalmol. 2021;21(1):92. Published 2021 Feb 18.
12. Song P, Xu Y, Zha M, Zhang Y, Rudan I. Global epidemiology of retinal vein occlusion: a systematic review and meta-analysis of prevalence, incidence, and risk factors. J Glob Health. 2019;9(1):010427.
13. Wong WL, Su X, Li X, et al. Global prevalence of age-related macular degeneration and disease burden projection for 2020 and 2040: a systematic review and meta-analysis. Lancet Glob Health. 2014;2(2):e106-e116.
14. Klein R, Knudtson MD, Lee KE, Gangnon R, Klein BE. The Wisconsin Epidemiologic Study of Diabetic Retinopathy XXIII: the twenty-five-year incidence of macular edema in persons with type 1 diabetes. Ophthalmology. 2009;116(3):497-503.
15. Cheung N, Mitchell P, Wong TY. Diabetic retinopathy. Lancet. 2010;376(9735):124-136.
16. Grunwald JE, Alexander J, Ying GS, et al. Retinopathy and chronic kidney disease in the Chronic Renal Insufficiency Cohort (CRIC) study. Arch Ophthalmol. 2012;130(9):1136-1144.
17. Sinclair A, Morley JE, Rodriguez-Mañas L, et al. Diabetes mellitus in older people: position statement on behalf of the International Association of Gerontology and Geriatrics (IAGG), the European Diabetes Working Party for Older People (EDWPOP), and the International Task Force of Experts in Diabetes. J Am Med Dir Assoc. 2012;13(6):497-502.
18. Browning DJ, Glassman AR, Aiello LP, et al. Relationship between optical coherence tomography-measured central retinal thickness and visual acuity in diabetic macular edema. Ophthalmology. 2007;114(3):525-536.
19. Scanlon PH. The English National Screening Programme for diabetic retinopathy 2003-2016. Acta Diabetol. 2017;54(6):515-525.
20. Wong TY, Sun J, Kawasaki R, et al. Guidelines on diabetic eye care: the International Council of Ophthalmology recommendations for screening, follow-up, referral, and treatment based on resource settings. Ophthalmology. 2018;125(10):1608-1622.
21. Simunovic MP, Hunyor AP, Ho IV. Vitrectomy for diabetic macular edema: a systematic review and meta-analysis. Can J Ophthalmol. 2014;49(2):188-195.
22. Vengadesan N, Ahmad M, Sindal MD, Sengupta S. Delayed follow-up in patients with diabetic retinopathy in South India: Social factors and impact on disease progression. Indian J Ophthalmol. 2017;65(5):376-384.
23. Lawrenson JG, Graham-Rowe E, Lorencatto F, et al. Interventions to increase attendance for diabetic retinopathy screening. Cochrane Database Syst Rev. 2018;1(1):CD012054.