DOI: https://doi.org/10.53350/pjmhs20221612631 ORIGINAL ARTICLE P J M H S Vol. 16, No. 12, December, 2022 631 Frequency of Diabetic Retinopathy Amongst Type 2 Diabetes Mellitus Patients MUBASHIR REHMAN 1 , JAMAL HUSSAIN 2 , IMRAN AHMAD 3 , ADNAN AHMAD 4 , MOHAMMAD FARHAN 5 , JAWAD HUMAYUN 6 1 MBBS, FCPS Ophthalmology, Associate Professor Department of Ophthalmology, Nowshera Medical College/ Qazi Hussain Ahmad Medical Complex Nowshera 2 MBBS, FCPS Ophthalmology, senior medical officer, Department of Ophthalmology, Timergara teaching hospital dir lower 3 MBBS, FCPS Ophthalmology, Assistant Professor Department of Ophthalmology Khyber Teaching Hospital MTI Peshawar 4 MBBS, FCPS Ophthalmology Assistant Professor Department of Ophthalmology Nowshera Medical College / Qazi Hussain Ahmad Medical Complex Nowshera 5 MBBS, FCPS Ophthalmology, Assistant Professor Department of Ophthalmology Nowshera Medical College/ Qazi Hussain Ahmad Medical Complex Nowshera 6 MBBS, FCPS Ophthalmology, Specialist Registrar department of Ophthalmology, Khyber Teaching Hospital MTI Peshawar Corresponding author: Imran Ahmad, Email: doctorimranahmad@gmail.com ABSTRACT Background: A chronic and debilitating condition called as diabetes is now a global epidemic problem. Patients in our population with 2 diabetes mellitus often develop diabetic retinopathy. Objective: To assess the diabetic retinopathy frequency amongst type 2 diabetes mellitus patients Methodology: The observational study was carried out at Ophthalmology, Department, Qazi Hussain Ahmad Medical Complex, Nowshera from January 2022 to July 2022. Ophthalmoscopy (Both direct and indirect) was done for the retinopathy and was then classified according to standard classification. All the data including age, gender and frequency of retinopathy was documented in a proforma designed for this research. IBM SPSS version 23 was used for data analysis. Results: In the current research, totally 320 type 2 diabetes mellitus patients were enrolled. There were 176 (55%) male patients while female patients were 144 (45%). Mean age (SD) of the enrolled patients in our study was 44 (12.5) years. The mean (SD) diabetes mellitus duration was 5.21 (2.56) years. In type 2 diabetes mellitus patients, the overall diabetic retinopathy frequency was 128 (49%). Conclusion: Our study concludes that the diabetic retinopathy prevalence is very high amongst type 2 diabetic patients. The prevalence of diabetic retinopathy is significantly increased due to lack of awareness and ophthalmic assessment. All the type 2 diabetic individuals should have routine ophthalmic evaluations. Keywords: Frequency; Diabetic retinopathy; Type 2 diabetes mellitus INTRODUCTION A chronic and debilitating condition called as diabetes is now a global epidemic problem. By 2030, it is expected that 439 million individuals would have diabetic retinopathy 1 . The diabetes mellitus prevalence in Pakistan is 11%, having the sixth highest population of patients with diabetes, with the forecast that it would rise to the fifth place by 2030 2, 3 . Approximately 60% of diabetes people acquire diabetic retinopathy within 20 years after diagnosis. Diabetic retinopathy affects 21% of diabetic patients at the time of diagnosis 4 . According to the World Health Organization (WHO), diabetic retinopathy is responsible for 4.8% cases of blindness 5 . The diabetic retinopathy prevalence in diabetes mellitus patients was found to be 34.6%, with over 10% having vision-threatening retinopathy, according to a meta-analysis 6 . By maintaining HBA1C below 7% decrease microvascular consequences, particularly in early phases of diabetic retinopathy and nephropathy, according to two studies 7 8 . Additionally, research show that although adequate glycaemic management does not entirely halt retinopathy, it does lower the chance of the condition progressing 9 . Therefore, it may lead to less need for therapy and eye preservation 9 . Both non-proliferative diabetic retinopathy and proliferative diabetic retinopathy are included in the diabetic retinopathy classification. Non-proliferative diabetic retinopathy is subdivided into severe, moderate, and mild forms. Microvascular blockage, the synthesis of vascular endothelial growth factor, and eventually neovascularization occur in severe disease. These fragile blood vessels might burst, resulting in bleeding. A tractional retinal detachment and irreversible vision loss might result with further advancement. According to a research conducted in Karachi, 55.3% of patients with diabetes had various stages of diabetic retinopathy 10 . Another research from Multan estimated that 73.1% of people had diabetic retinopathy 11 . Another multicenter research report reported that the prevalence was 56.9% 12 . On the other hand, a significant research with 11,158 patients found that 24.7% of patients developed diabetic retinopathy 13 . Only 22.7% of type 2 diabetes individuals were found in another Lahore-based investigation 14 . In Hyderabad district, prevalence was reported to be as low as 17% 15 . Our goal was to evaluate the diabetic retinopathy frequency in type 2 diabetes mellitus individuals since the frequency of the condition varies among studies and has not been examined in our setting. MATERIALS AND METHODS The current observational study was carried out at the Ophthalmology Department, Qazi Hussain Ahmad Medical Complex, Nowshera for a duration of six months from January 2022 to July 2022. The ethical approval of the study was taken from the IRB of the hospital. A total of 320 patients were enrolled in our study. Our study inclusion criteria were patients of both the gender having age 18-80 years, diagnosed with diabetes mellitus and willing to participate in our study. The exclusion criteria for our study were all the patients with sickle cell retinopathy, retinal artery occlusion, hypertension and retinal vasculitis. The informed consent was taken from all the participants of the current research. All the enrolled patients were examined clinically. Ophthalmoscopy (Both direct and indirect) was done for the retinopathy and was then classified according to standard classification. All the data including age, gender and frequency of retinopathy was documented in a proforma designed for this research. IBM SPSS version 23 was employed for analysis of data. Age and diabetes duration were documented as mean (± SD) while gender and retinopathy in diabetic patients were documented as percentage and frequency. RESULTS In the current research, totally 320 type 2 diabetes mellitus patients were enrolled. There were 176 (55%) male patients while female patients were 144 (45%). (Figure 1) The mean age (SD) of the enrolled patients was 44 (12.5) years. The mean (SD) diabetes mellitus duration was 5.21 (2.56) years. The overall diabetic retinopathy frequency was 128 (49%) in type 2 diabetes mellitus patients. (Figure 2) Based on classification of diabetic retinopathy, 74 (57.81%) patients were observed with Background retinopathy, 32 (25%) patients were observed with Preproliferative retinopathy