Six year incidence and progression of diabetic retinopathy: Results from the Mauritius diabetes complication study

Tapp, Robyn J.; Zimmet, Paul Z.; Harper, C. Alex; McCarty, Daniel J.; Chitson, Pierrot; Tonkin, Andrew M.; Söderberg, Stefan; Taylor, Hugh R.; Alberti, K.G.M.M.; Tuomilehto, Jaakko; Shaw, Jonathan E.

doi:10.1016/j.diabres.2006.02.009

« Previous Next »Diabetes Research and Clinical Practice
Volume 73, Issue 3 , Pages 298-303, September 2006

Six year incidence and progression of diabetic retinopathy: Results from the Mauritius diabetes complication study

Robyn J. Tapp
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
- International Diabetes Institute, Melbourne, Australia
- Corresponding author at: Department of Epidemiology and Preventive Medicine, Central and Eastern Clinical School, Monash University, Alfred Hospital, Prahran, Vic. 3004, Australia. Tel.: +61 9903 0542; fax: +61 9903 0576.
Paul Z. Zimmet
- International Diabetes Institute, Melbourne, Australia
C. Alex Harper
- Centre for Eye Research Australia, The University of Melbourne, Australia
Daniel J. McCarty
- International Diabetes Institute, Melbourne, Australia
Pierrot Chitson
- Ministry of Health and Quality of Life, Mauritius
Andrew M. Tonkin
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
Stefan Söderberg
- International Diabetes Institute, Melbourne, Australia
Hugh R. Taylor
- Centre for Eye Research Australia, The University of Melbourne, Australia
K.G.M.M. Alberti
- Department of Medicine, University of Newcastle, Newcastle upon Tyne, UK
Jaakko Tuomilehto
- Department of Epidemiology and Health Promotion, National Public Health Institute, Helsinki, Finland
Jonathan E. Shaw
- International Diabetes Institute, Melbourne, Australia

Received 13 June 2005; received in revised form 13 December 2005; accepted 8 February 2006. published online 03 April 2006.

Abstract

Aims

To determine the incidence, progression and risk factors for diabetic retinopathy in the multiethnic population of Mauritius.

Method

A longitudinal, population-based study was conducted in Mauritius, during 1987, 1992 and 1998. Participants identified through the study as having diabetes (both known and newly diagnosed, by self-report and oral glucose tolerance test) and one in four participants with impaired glucose tolerance (IGT) underwent complications screening in 1992 and 1998. Retinal photographs were taken using a TRC-50VT retinal camera in three fields of the right eye (centred on the optic disc; macula (temporal to the optic disc); and nasal to disc). Photographs were graded according to a simplified version of the Wisconsin grading system.

Results

The 6-year incidence of diabetic retinopathy was 23.8% (sight-threatening in 0.4%). Among those with known diabetes mellitus (KDM) and free of retinopathy at baseline the incidence of non-proliferative diabetic retinopathy (NPDR) was 29.2% and proliferative diabetic retinopathy (PDR) was 1.0%. Among those with newly diagnosed diabetes mellitus (NDM) at baseline the incidence of NPDR was 19.1% (no incident cases of PDR were found). Independent risk factors for retinopathy using the baseline population characteristics were duration of diabetes and fasting plasma glucose.

Conclusions

This is one of the few recent population-based studies of diabetic retinopathy undertaken in a developing nation. The incidence of retinopathy in Mauritius was high among those with NDM at baseline, with one in five developing retinopathy over 6 years. These results support the concept that screening for diabetes is important.

Keywords: Diabetic retinopathy, Mauritius, Diabetes mellitus