Prevalence and associated factors of diabetic retinopathy among type 2 diabetes mellitus patients in Brunei Darussalam - A cross-sectional study.

Purpose To determine the prevalence of diabetic retinopathy (DR) and the factors associated with retinopathy among type-2 diabetes mellitus (DM) patients in Brunei Darussalam. Method Cross-sectional study of all T2DM patients who attended diabetic eye screening over a three-month period at one of four government hospitals. We assessed association between DR with the following variables: age, gender, glycated haemoglobin (HbA1c), duration of DM, hypertension, hyperlipidaemia, and microalbuminuria. Results There were 341 patients (female 58.9%; mean age 55.3 ± 11.9 yrs.) with a mean duration of DM of 9.4 ± 7.4 yrs. and mean serum HbA1c of 8.4 ± 1.9%. The overall prevalence of any DR was 22.6% (95% CI: 18.8-27.1) with prevalence rates of 4.1% (95% CI: 2.1- 6.4) for proliferative DR (PDR) and 9.7% (95% CI: 6.8-13.2) for vision threatening DR (VTDR). Multivariate analysis showed that DR was significantly associated with certain age groups (reduced in older age groups), longer duration of DM (11yrs or more), poor control (HbA1c > 9.0%) and presence of any microalbuminuria. Conclusion DR affects one in five patients with DM in Brunei Darussalam, comparable to rates reported for other Asian populations. It is especially worrying that one in ten patients with DM had VTDR. DR was significantly associated with longer duration of DM, poor control and presence of microalbuminuria but reduced in older age groups. It is important to advocate good control right from the time of diagnosis of DM and institute timely and effective management of retinopathy.