title: Prevalence of retinopathy among adults with self-reported diabetes mellitus: the Sri Lanka diabetes and Cardiovascular Study.
abstract: BACKGROUND
  At present there are no large scale nationally-representative studies from Sri Lanka on the prevalence and associations of Diabetic Retinopathy (DR). The present study aims to evaluate the prevalence and risk factors for DR in a community-based nationally-representative sample of adults with self-reported diabetes mellitus from Sri Lanka.
  
  
  METHODS
  A cross-sectional community-based national study among 5,000 adults (≥18 years) was conducted in Sri Lanka, using a multi-stage stratified cluster sampling technique. An interviewer-administered questionnaire was used to collect data. Ophthalmological evaluation of patients with 'known' diabetes (previously diagnosed at a government hospital or by a registered medical practitioner) was done using indirect ophthalmoscopy. A binary-logistic regression analysis was performed with 'presence of DR' as the dichotomous dependent variable and other independent covariates.
  
  
  RESULTS
  Crude prevalence of diabetes was 12.0% (n = 536), of which 344 were patients with 'known' diabetes. Mean age was 56.4 ± 10.9 years and 37.3% were males. Prevalence of any degree of DR was 27.4% (Males-30.5%, Females-25.6%; p = 0.41). In patients with DR, majority had NPDR (93.4%), while 5.3% had maculopathy. Patients with DR had a significantly longer duration of diabetes than those without. In the binary-logistic regression analysis in all adults duration of diabetes (OR:1.07), current smoking (OR:1.67) and peripheral neuropathy (OR:1.72) all were significantly associated with DR.
  
  
  CONCLUSIONS
  Nearly 1/3rd of Sri Lankan adults with self-reported diabetes are having retinopathy. DR was associated with diabetes duration, cigarette smoking and peripheral neuropathy. However, further prospective follow up studies are required to establish causality for identified risk factors.
authors.affiliation: Diabetes Research Unit, Department of Clinical Medicine, Faculty of Medicine, University of Colombo, Kynsey Road, Colombo, Sri Lanka. pkatulanda@yahoo.com.
authors.forename: Prasad
authors.initials: P
authors.lastname: Katulanda
authors.forename: Priyanga
authors.initials: P
authors.lastname: Ranasinghe
authors.forename: Ranil
authors.initials: R
authors.lastname: Jayawardena
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000453:epidemiology*; D003930:Diabetic Retinopathy / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D009887:Ophthalmoscopy; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D057566:Self Report; D013188:Sri Lanka / Q000453:epidemiology
chemical_list: D006442:Glycated Hemoglobin