Prevalence and Associated Factors of Diabetic Retinopathy among Type 2 Diabetes Mellitus Patients in Brunei Darussalam: A Cross-sectional Study

Purpose: To determine the prevalence of diabetic retinopathy (DR) and the factors associated with retinopathy among type2 diabetes mellitus (DM) patients in Brunei Darussalam. Methods: Cross-sectional study of all type 2 DM patients who attended diabetic eye screening over a 3-month period at oneof four government hospitals. We assessed association between DR with the following variables: age, sex, glycated hemoglobin(HbA1c), duration of DM, hypertension, hyperlipidemia, and microalbuminuria. Results: There were 341 patients (female, 58.9%; mean age, 55.3 ± 11.9 years) with a mean duration of DM of 9.4 ± 7.4 yearsand mean serum HbA1c of 8.4% ± 1.9%. The overall prevalence of any DR was 22.6% (95% confidence interval, 18.8–27.1)with prevalence rates of 4.1% (95% confidence interval, 2.1–6.4) for proliferative DR and 9.7% (95% confidence interval,6.8–13.2) for vision-threatening DR. Multivariate analysis showed that DR was significantly associated with certain age groups(reduced in older age groups), longer duration of DM (11 years or more), poor control (HbA1c >9.0%) and presence of any microalbuminuria. Conclusions: DR affects one in five patients with DM in Brunei Darussalam, comparable to rates reported for other Asianpopulations. It is especially worrying that one in ten patients with DM had vision-threatening DR. DR was significantly associatedwith longer duration of DM, poor control and presence of microalbuminuria but reduced in older age groups. It isimportant to advocate good control right from the time of diagnosis of DM and institute timely and effective management ofretinopathy. DR was significantly associated with longer duration of DM, poor control of diabetes, and presence of microalbuminuriabut reduced in older age groups.