[Relationship between pulse pressure, visual impairement and severity of diabetic retinopathy in sub-Saharan Africa].
OBJECTIVE
To determine the relationship between pulse pressure, traditional risk factors, vision impairment and different clinical forms of diabetic retinopathy.


METHODS
A cross-sectional study was conducted between December 1st, 2004 and July 16th, 2005 within the care centers of Kinshasa, DRC. The origin population (n=3010 diabetics) served to estimate the diabetic retinopathy prevalence while a random sample of 301 diabetics participated to this analytic study: age>or=20 years, anthropometry, components of blood pressure, fasting glycaemia, optometry, fundoscopy, stages of diabetic retinopathy.


RESULTS
The rate of diabetic retinopathy was 31.6% 95 CI: 26.3-36.9 in Kinshasa town. In the random sample, diabetic retinopathy was non proliferative in the majority (90%). Subjective decrease of acuity was associated with diabetic retinopathy in the sample (OR=2.7; 95% CI 1.1-5.4; p<0.05), among women (OR=2.7; 95% CI 1.3-5.7; p<0.05), and in patients with type 2-diabetes (OR=2; 95% CI 1.1-3.4; p<0.05). Objective decrease of acuity was associated with diabetic retinopathy in the study sample (OR=3.6; 95% CI 1.1-12.6; p<0.05). Visual impairment was significantly associated with diabetic retinopathy in women (OR=3.6; 95% CI 1.1-12.6; p<0.05) and proliferative diabetic retinopathy. Pregnancy after diabetes mellitus onset was a significant risk factor of diabetic retinopathy for women (OR=3.2; 95% CI 1.1-13.2; p<0.05). Using logistic regression analysis, family history of diabetic retinopathy (OR=3.2; 95% CI 1.2-8.8; p<0.05), diabetes duration >/=4 years (OR=3.4; 95% CI 1.4-8.5; p<0.01), and pulse pressure>or=60 mmHg (OR=5; 95% CI 2-12.8; p<0.001) were the independent and significant predictors of diabetic retinopathy.


CONCLUSIONS
Urgent programme of prevention and control of diabetic retinopathy and its risk factors is needed.
Nkondi Mbadi
A Nsungu J
AN
Service d’Ophtalmologie, Hôpital Général de référence de Kinshasa et Université de Kinshasa, RD Congo.
Longo-Mbenza
B
B
Mvitu Muaka
M
M
Mbungu
Fuele S
FS
Lemogoum
D
D
D001766:Blindness / Q000209:etiology*; D003430:Cross-Sectional Studies; D015023:Democratic Republic of the Congo; D003930:Diabetic Retinopathy / Q000150:complications* / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011674:Pulse; D012720:Severity of Illness Index