Articles Tập 67 Số CĐ13-HNKH Bệnh viện 19-8 09/09/2026

PREVALENCE AND CLINICAL CHARACTERISTICS OF DIABETIC RETINOPATHY AMONG PATIENTS WITH DIABETES MANAGED AT PRIMARY HEALTH CARE FACILITIES IN NGHE AN PROVINCE IN 2023

Du Hai Nam1,2, Tran Tat Thang1,2, Duong Dinh Chinh3,4, Mai Van Anh Khoa5,6, Tran Nhu Khoa7,8
1 Nghe An Eye Hospital
2 Bệnh viện Mắt Nghệ An
3 Nghe An Department of Health
4 Sở Y tế tỉnh Nghệ An
5 Health Center of Hai Chau
6 Trung tâm Y tế khu vực Hải Châu
7 Air Defence - Air Force Medical Institute
8 Viện Y học Phòng không Không quân
DOI: 10.52163/yhc.v67iCD13.6509
0 Views
0 Downloads
Keywords
diabetic retinopathy; diabetic macular edema; prevalence; diabetes mellitus; primary health care; Vietnam.
Abstract

 

Background

Diabetic retinopathy (DR) is a common microvascular complication of diabetes mellitus and one of the leading causes of preventable visual impairment among working-age adults. Epidemiological evidence from primary health care settings is essential for planning effective diabetic eye screening programmes, particularly in low- and middle-income countries.

Objective

To determine the prevalence, clinical characteristics and distribution of diabetic retinopathy among patients with diabetes managed at primary health care facilities in Nghe An Province, Vietnam.

Methods

A cross-sectional study was conducted in 2023 among 360 adults aged 40 years or older with diagnosed diabetes type 2 receiving routine management at primary health care facilities in three representative districts of Nghe An Province. All participants underwent comprehensive ophthalmic examination, including best-corrected visual acuity assessment, dilated fundus examination using slit-lamp biomicroscopy with a Volk 90D lens, and diabetic retinopathy grading according to the International Clinical Diabetic Retinopathy Disease Severity Scale (ICDR).

Results

The overall prevalence of diabetic retinopathy was 28.6% (103/360). Mild, moderate, severe non-proliferative diabetic retinopathy and proliferative diabetic retinopathy accounted for 10.3%, 8.3%, 5.0%, and 5.0% of the study population, respectively. Diabetic macular edema was identified in 6.1% of participants, while 10.3% had vision-threatening diabetic retinopathy. The prevalence of DR increased with age, longer duration of diabetes and poorer glycaemic control. Participants with HbA1c ≥7.0% had a higher prevalence of DR than those with HbA1c <7.0% (33.8% vs. 20.0%). Similarly, participants with diabetes duration ≥10 years had a substantially higher prevalence than those with disease duration <5 years (36.1% vs. 16.7%).

Conclusions

Diabetic retinopathy is a common ocular complication among patients with diabetes managed at primary health care facilities in Nghe An Province. The substantial proportion of patients with diabetic macular edema and vision-threatening diabetic retinopathy indicates a considerable burden of vision-threatening disease. These findings provide epidemiological evidence supporting the implementation of systematic diabetic retinopathy screening programmes for early detection and timely management at the primary health care level.

References
[1]
1. Cheung N, Mitchell P, Wong T.Y. (2010). Diabetic retinopathy. Lancet, 376(9735), 124–136. DOI 10.1016/S0140-6736(09)62124-3 Google Scholar
[2]
2. Teo Z.L, Tham Y.C, Yu M và cộng sự. (2021). Global Prevalence of Diabetic Retinopathy and Projection of Burden through 2045: Systematic Review and Meta-analysis. Ophthalmology, 128(11), 1580–1591. DOI 10.1016/j.ophtha.2021.04.027 Google Scholar
[3]
3. Early Treatment Diabetic Retinopathy Study Research Group (1991). Early photocoagulation for diabetic retinopathy. ETDRS report number 9. Ophthalmology, 98(5 Suppl), 766–785. Google Scholar
[4]
4. Lim J.I, Kim S.J, Bailey S.T và cộng sự. (2025). Diabetic Retinopathy Preferred Practice Pattern®. Ophthalmology, 132(4), P75–P162. DOI 10.1016/j.ophtha.2024.11.019 Google Scholar
[5]
5. Wong T.Y , Jenifer S, Ryo K và cộng sự. (2018). Guidelines on Diabetic Eye Care: The International Council of Ophthalmology Recommendations for Screening, Follow-up, Referral, and Treatment Based on Resource Settings. Ophthalmology, 125(10). DOI 10.1016/j.ophtha.2018.04.007 Google Scholar
[6]
6. American Diabetes Association Professional Practice Committee (2025). 12. Retinopathy, Neuropathy, and Foot Care: Standards of Care in Diabetes-2025. Diabetes Care, 48(1 Suppl 1), S252–S265. DOI 10.2337/dc25-S012 Google Scholar
[7]
7. Nguyễn Thị Thủy Tiên và Trần Đình Tùng (2024). Khảo sát bệnh lý võng mạc đái tháo đường trên bệnh nhân điều trị tại bệnh viện Thống Nhất. Tạp chí Y học cộng đồng Việt Nam, 65(10), 410–418. Google Scholar
[8]
8. Yau J.W.Y, Rogers S.L, Kawasaki R và cộng sự. (2012). Global Prevalence and Major Risk Factors of Diabetic Retinopathy. Diabetes Care, 35(3), 556–564. DOI 10.2337/dc11-1909 Google Scholar
[9]
9. Wilkinson C.P, Ferris F.L, Klein R.E và cộng sự. (2003). Proposed international clinical diabetic retinopathy and diabetic macular edema disease severity scales. Ophthalmology, 110(9), 1677–1682. DOI 10.1016/S0161-6420(03)00475-5 Google Scholar
[10]
10. Diabetes Control and Complications Trial Research Group, Nathan D.M, Genuth S. và cộng sự. (1993). The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med, 329(14), 977–986. DOI 10.1056/NEJM199309303291401 Google Scholar
[11]
11. UK Prospective Diabetes Study (UKPDS) (1998). Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Group. Lancet, 352(9131), 837–853. DOI 10.1016/S0140-6736(98)07019-6 Google Scholar
[12]
12. World Health Organization (2020), Strengthening diagnosis and treatment of Diabetic Retinopathy in SEA Region, New Delhi: , Regional Office for South-East Asia. Google Scholar