title: Prevalence of diabetic retinopathy in Peruvian patients with type 2 diabetes: results of a hospital-based retinal telescreening program.
abstract: OBJECTIVE
  To estimate the prevalence of diabetic retinopathy (DR) in patients with type 2 diabetes and to determine any association with clinical factors.
  
  
  METHODS
  This hospital-based screening project was designed to prospectively detect the presence of DR in patients with type 2 diabetes by grading images acquired with a digital retinal camera.
  
  
  RESULTS
  Of 1 311 patients screened, appropriate retinal images were obtained in 1 222 subjects (93.2%). DR was detected in 282 patients (23.1%) [95% confidence interval (CI): 20.71-25.44]; 249 patients (20.4%) (95% CI: 18.1-22.6) had nonproliferative DR and 33 (2.7%) (95% CI: 1.8-3.6) had proliferative DR. In 32 patients (11.3%), DR was unilateral. The frequency of DR was the same in both sexes. Prevalence of blindness was twice as frequent in patients with DR as in those without it (9.4% and 4.6%, respectively) (P = 0.001). The frequency of DR at diagnosis was 3.5% and it increased with the duration of diabetes. DR was more frequent in patients with arterial hypertension, macrovascular or microvascular complications, and hemoglobin A1c (HbA1c) > 7.0% and in those treated with insulin or sulfonylureas. It was less prevalent in those with HbA1c < 7.0%, with greater body mass index, and who had been treated with metformin.
  
  
  CONCLUSIONS
  The prevalence of DR in these patients with type 2 diabetes was 23.1%. Nonproliferative retinopathy accounted for 77.0% of cases. Although less prevalent than in a previous report, it doubled the frequency of blindness in the people affected. A national screening DR program should be considered in order to detect this prevalent condition early and treat it in a timely fashion.
authors.affiliation: Department of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru.
authors.forename: Jaime E
authors.initials: JE
authors.lastname: Villena
authors.forename: Christian A
authors.initials: CA
authors.lastname: Yoshiyama
authors.forename: Javier E
authors.initials: JE
authors.lastname: Sánchez
authors.forename: Nélida L
authors.initials: NL
authors.lastname: Hilario
authors.forename: Lawrence M
authors.initials: LM
authors.lastname: Merin
mesh_terms: D000368:Aged; D001766:Blindness / Q000453:epidemiology / Q000209:etiology; D015897:Comorbidity; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy / Q000453:epidemiology*; D003925:Diabetic Angiopathies / Q000453:epidemiology; D003930:Diabetic Retinopathy / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology; D005260:Female; D005654:Fundus Oculi; D006442:Glycated Hemoglobin / Q000032:analysis; D006779:Hospitals, Public / Q000458:organization & administration*; D006785:Hospitals, University / Q000458:organization & administration*; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007391:International Cooperation; D008297:Male; D008403:Mass Screening; D008687:Metformin / Q000627:therapeutic use; D008875:Middle Aged; D010568:Peru / Q000453:epidemiology; D010781:Photography / Q000379:methods; D015995:Prevalence; D011446:Prospective Studies; D012160:Retina / Q000473:pathology*; D017216:Telemedicine; D014792:Visual Acuity
chemical_list: D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D008687:Metformin