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. 2021 Jan;28(1):775-784.
doi: 10.1016/j.sjbs.2020.11.010. Epub 2020 Nov 11.

Diabetic retinopathy in the Eastern Morocco: Different stage frequencies and associated risk factors

Jamila Hammoudi  1 , Nour El Houda Bouanani  1 , El Habri Chelqi  2 , Yassamine Bentata  3 , Hamid Nouayti  1 , Abdelkhaleq Legssyer  1 , Abderrahim Ziyyat  1
Affiliations

Diabetic retinopathy in the Eastern Morocco: Different stage frequencies and associated risk factors

Jamila Hammoudi et al. Saudi J Biol Sci. 2021 Jan.

Abstract

Diabetes is a major cause of morbidity and mortality worldwide. It can affect many organs and, over time, leads to serious complications. Diabetic retinopathy (DR), a specific ocular complication of diabetes, remains the leading cause of vision loss and vision impairment in adults. This work is the first in Eastern Morocco aimed at identifying the different stages of DR and to determine their frequencies and associated risk factors. It is a case-control study conducted from December 2018 to July 2019 at the ophthalmology department of Al-Irfane Clinic (Oujda). Data were obtained from a specific questionnaire involving 244 diabetic patients (122 cases with retinopathy vs 122 controls without retinopathy). All results were analyzed by the EPI-Info software. This study shows a predominance of proliferative diabetic retinopathy (PDR) with 57.4% of cases (uncomplicated proliferative diabetic retinopathy (UPDR): 23.8%; complicated proliferative diabetic retinopathy (CPDR): 33.6%). The non-proliferative diabetic retinopathy (NPDR) represents 42.6% (minimal NPDR: 8.2%; moderate NPDR: 26.2%; severe NPDR: 8.2%). The determinants of DR were insulin therapy, high blood pressure, poor glycemic control and duration of diabetes. Regarding the chronological evolution, retinopathy precedes nephropathy. Diabetic nephropathy (DN) was present in 10.6% of cases especially in patients with PDR. In summary, the frequency of PDR was higher than that of NPDR. DR appears before DN with a high frequency of DN in patients with PDR. Good glycemic control and blood pressure control, as well as early diagnosis are the major preventive measures against DR.

Keywords: Diabetic nephropathy; Diabetic retinopathy; Eastern Morocco; Risk factors.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Distribution of cases and controls according to diabetes duration. *P < 0.0001 cases compared to controls for diabetes duration >15 years.
Fig. 2
Fig. 2
Fluorescein angiography showing clinical features of non-proliferative (minimal, moderate and severe stages) and proliferative diabetic retinopathy (red images before fluorescein injection; black and white images after fluorescein injection).
Fig. 3
Fig. 3
Frequency of DR stages. NPDR: non-proliferative diabetic retinopathy; Minimal NPDR: minimal non-proliferative diabetic retinopathy; Moderate NPDR: moderate non-proliferative diabetic retinopathy; Severe NPDR: severe non-proliferative diabetic retinopathy; PDR: proliferative diabetic retinopathy; UPDR: uncomplicated proliferative diabetic retinopathy; CPDR: complicated proliferative diabetic retinopathy.
Fig. 4
Fig. 4
Frequency of diabetic nephropathy according to DR stages. It should be noted that the DN was based only on patient's statement. Minimal NPDR: minimal non-proliferative diabetic retinopathy; Moderate NPDR: moderate non-proliferative diabetic retinopathy; Severe NPDR: severe non-proliferative diabetic retinopathy; UPDR: uncomplicated proliferative diabetic retinopathy; CPDR: complicated proliferative diabetic retinopathy.
See this image and copyright information in PMC

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