The prevalence of and major risk factors associated with diabetic retinopathy in Gegharkunik province of Armenia: cross-sectional study.
BACKGROUND
Diabetic retinopathy (DR) is one of the leading causes of blindness in adults in industrialized countries and the emerging cause of blindness in developing countries. The objective of this study was to describe the prevalence of DR and risk factors associated with it among diabetic patients.


METHODS
The analytical cross-sectional survey and eye screenings were carried out among 625 diabetic patients from urban and rural areas of Gegharkunik region. DR was assessed by dilated ophthalmoscopy and defined based on the WHO International Classification of Diseases. The survey instrument, included questions about demographics, disease history, health status, medication use and healthy lifestyle. Descriptive statistics and logistic regression were used to analyze the data.


RESULTS
The prevalence of DR in the sample was 36.2%. A total of 90.2% of patients with DR had non-proliferative, while 9.8% had proliferative DR. In bivariate analysis, age, diabetes duration, being under insulin treatment, blood glucose level, having non-communicable diseases were significantly associated with DR. In the adjusted analysis being under insulin treatment (OR = 3.24; 95% CI: 1.56-6.75), diabetes duration (OR = 1.23; 95% CI: 1.16-1.31) and age (OR = 1.05; 95% CI: 1.02-1.08) were independently associated with DR.


CONCLUSIONS
Earlier diagnosis of diabetes and DR can help to control some of these factors and prevent further complications and vision loss. Population-based educational programs on diabetes and diabetic retinopathy and continuous medical education on diabetes management can improve diabetes care and self-management and prevent eye complications.
Garo Meghrigian Institute for Preventive Ophthalmology, School of Public Health, American University of Armenia, 40 Marshal Baghramian Ave., Yerevan, 0019, Armenia. aida@aua.am.
Aida
A
Giloyan
School of Public Health, American University of Armenia, 40 Marshal Baghramian Ave., Yerevan, 0019, Armenia. tsovinar@aua.am.
Tsovinar
T
Harutyunyan
School of Public Health, American University of Armenia, 40 Marshal Baghramian Ave., Yerevan, 0019, Armenia. vpetrosi@aua.am.
Varduhi
V
Petrosyan
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001136:Armenia / Q000453:epidemiology; D001766:Blindness / Q000453:epidemiology / Q000209:etiology*; D003430:Cross-Sectional Studies; D003930:Diabetic Retinopathy / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009887:Ophthalmoscopy; D015995:Prevalence; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D012424:Rural Population; D011795:Surveys and Questionnaires; D055815:Young Adult