Prevalence and Associated Risk Indicators of Retinopathy in a Rural Bangladeshi Population with and without Diabetes

Purpose: To determine the prevalence of retinopathy among people with normal and abnormal glucose metabolism in a remote rural community of Bangladesh, and to identify the associated risk indicators for developing retinopathy in this population. Methods: A population-based cross-sectional study was conducted through screening in camp settings, which included a total of 836 participants (468 male and 368 female) aged 30 years or over. Retinopathy was determined by fundus photography. Anthropometric measures (body mass index and waist-to-hip ratio), oral glucose tolerance, glycosylated hemoglobin (HbA(1)c), blood pressure, lipid profile, serum creatinine and urine albumin creatinine ratio (UACR) were measured. Logistic regression analysis was used with adjustment for potential confounders. Results: The overall prevalence of retinopathy was 5.4% (95% confidence interval, CI, 3.9-6.9). The prevalence rates of retinopathy among diabetic, impaired glucose regulation and non-diabetic subjects were 21.6%, 13% and 3.5%, respectively. Adjusted odds ratios for retinopathy were 2.53 (95% CI 1.52-5.41) for abnormal glucose metabolism and 1.98 (95% CI 1.17-5.63), 1.74 (95% CI 1.09-3.02) and 1.63 (95% CI 1.08-3.12) for hypertension, HbA(1)c and UACR, respectively. Additionally, age, body mass index, triglyceride and total cholesterol were also found to be significant independent risk indicators for the occurrence of retinopathy in this population. Conclusion: A high prevalence of retinopathy was observed in this rural Bangladeshi population. In addition to blood glucose control for diabetes, screening for hypertension, obesity, hyperlipidemia and proteinuria as well as adequate treatment of these risk indicators may prevent retinopathy in rural Bangladeshi populations.