Epidemiological Features of Diabetic Retinopathy at the Yaoundé Gyneco-Obstetric and Pediatric Hospital

Nomo AF^1,2*, Nyouma PJ³, Nanfack NC^1,2, Menye JH¹, Mvilongo TC^1,4, Hassan A³, Emah M¹, Mare NJ⁵, Akono Zoua Me^1,4, Koki G^1,6, Omgbwa EA^1,7, Bella AL^1,2

¹Faculty of Medicine and Biomedical Sciences of the University of Yaoundé I, Cameroon
²Yaoundé Gyneco-Obstetric and Pediatric Hospital, Cameroon
³Faculty of Medicine and Pharmaceutical Sciences of Douala, Cameroon
⁴Yaoundé Central Hospital, Cameroon
⁵Faculty of Medicine and Biomedical Sciences of the University of Garoua, Cameroon
⁶Douala Military Hospital, Cameroon
⁷Yaoundé Teaching Hospital, Cameroon

*Correspondence author: Nomo Arlette Francine, Faculty of Medicine and Biomedical Sciences of the University of Yaoundé I, Cameroon and Yaoundé Gyneco-Obstetric and Pediatric Hospital, Cameroon; Email: nomoarlette2011@yahoo.fr 

Citation: Nomo AF, et al. Epidemiological Features of Diabetic Retinopathy at the Yaoundé Gyneco-Obstetric and Pediatric Hospital. J Ophthalmol Adv Res. 2025;6(3):1-5.

Copyright^© 2025 by Nomo AF, et al. All rights reserved. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Table 1: Distribution of patients by gender.

Table 2: Distribution of patients according to age group.

Table 3: Distribution of the population according to profession.

Refractive error (n=102, 87.93%) was the most common ophthalmological condition and 8 (6.89%) patients had undergone cataract surgery. Hypertension was the most common family history at 41.37%. Regarding the characteristics of diabetes, type 2 diabetes predominated at 90.51%. The duration of diabetes was greater than 10 years in 79 (68.10%) patients and poor glycemic control was found in 108 (68.10%) patients. The pathologies associated with diabetic retinopathy were hypertension (86.20%), dyslipidemia (18.96%) and renal failure (9.48%).

Among the 232 eyes with diabetic retinopathy, 62.06% had developed Non-Proliferative Diabetic Retinopathy (NPDR) and 37.94% had Proliferative Diabetic Retinopathy (PDR). After multivariate analysis, the risk factors associated with diabetic retinopathy were the duration of diabetes, poor glycemic control, hypertension, hyperlipidemia and renal failure (P<0.001) (Table 4).

Table 4: Multivariate analysis between risk factors and diabetic retinopathy.

Discussion

In our study, the most represented age group was 60 to 70 years (37.93%). This predominance of older subjects corroborates a study conducted in the Democratic Republic of Congo which showed that the frequency of diabetic retinopathy increased significantly with age [7]. The average age of the patients was close to that of Lebonzo Essende, et al. and Nanfack, et al., who reported average ages of 60 and 58.2 years, respectively [1,4]. These similarities suggest that Diabetic Retinopathy (DR) primarily affects older subjects, probably due to prolonged exposure to the metabolic disturbances of diabetes. A female predominance was also observed in Ousmane, (72%) and Oumar T, (71.2%) [4,8]. This female predominance could be explained by the fact that men generally consult less frequently than women and the Yaoundé Gyneco-Obtetric and pediatric Hospital is a healthcare facility specializing in mother and child care. The global prevalence of diabetic retinopathy ranges from 10% to 80%, while African studies indicate a range of 15% to 52% [9]. This demonstrates the variability of this prevalence across different studies. In Europe, the prevalence of diabetic retinopathy has been estimated at 30% in France [10]. In America, it has been estimated at 33% in the USA [7]. In our series, we found a prevalence of 30.93%, which is close to the aforementioned studies [7,10]. This frequency is lower than that reported by Ousmane M, in Bamako (37%), Koki, et al., in Cameroon in 2010 (42%), Nanfack, et al., (39.9%) and Amine, et al., which was 57% [5,6,8,9]. However, the variation in these rates could be explained by risk factors for Diabetic Retinopathy (DR): hypertension, glycemic control, duration of diabetes and type of diabetes. Currently, efforts are being made by patients and healthcare professionals to improve diabetes management.

The risk factors identified in our study were: poor glycemic control, duration of diabetes and hypertension. These same risk factors have been reported in Côte d’Ivoire and Cameroon [6,11]. Factors associated with the progression of Diabetic Retinopathy (DR) include pregnancy, adolescence, renal insufficiency, puberty, diabetes management and ocular surgery. However, in our study, only renal insufficiency (9.48%) was found to have a statistically significant association with DR. According to some authors, glycemic control is assessed by blood glucose levels, as in the study by Lebonzo, et al., in which patients with retinopathy had blood glucose levels > 1.40 g/L and by Koki, with 86.96% hyperglycemia [3,5]. It is also assessed by glycated Hemoglobin (HbA1c) levels, as in the study by Nanfack, et al., which reported a mean HbA1c level of 9.7% [6]. For most authors who used glycated Hemoglobin (HbA1c) levels as a reference, poor glycemic control is synonymous with a high prevalence and severity of diabetic retinopathy. For others who used the values of recent blood glucose levels as a criterion for judging the quality of glycemic control, the results are inconsistent [9]. In our study, both parameters were analyzed, with more than half (93.10%) of the patients having HbA1c >7%. The results showed that poor glycemic control had a statistically significant impact on the development of diabetic retinopathy (p<0.001), thus concordant with the results of Chakib, et al., who found 79% of patients with poor blood glucose [9]. The duration of diabetes is a major risk factor in the onset and progression of diabetic retinopathy. In our study, this risk increased significantly after ten years, which corroborates the results of Aynaou, et al. in 2015, who reported an average duration of disease progression of between 10 and 15 years in affected patients [3]. Similarly, Chakib A, Oumar T, and Klein R. reported prevalences of 70% after 15 to 20 years of diabetes, 20.8% after more than 10 years and up to 90% after 20 years of disease progression, respectively [4,7,9]. This long period before the onset of lesions can be explained by the often late diagnosis of type 2 diabetes in our setting, with the disease frequently being discovered incidentally when complications arise. This situation reflects persistent shortcomings in the early detection and management of diabetes, thus promoting the silent progression of the disease to severe ocular damage. The prevalence of hypertension in our study was higher than that found by Nanfack, et al., in 2010 (60.1%) and by Ousmane, et al., in Mali (30.8%) [6,8]. This prevalence is close to that of Lebonzo E, et al., (73.3%) [2].

Several studies have investigated the association between hypertension and the risk of developing diabetic retinopathy. The majority of authors found a positive correlation between high blood pressure and the prevalence of diabetic retinopathy, as exemplified by Kouassi, et al., who demonstrated a statistically significant association between two risk factors, including hypertension (29.7%) [11]. Our study also found a statistically significant association between hypertension and the risk of developing diabetic retinopathy.

The limitation of this study lies in its retrospective nature, with some patient records missing and data incomplete.

Conclusion

Diabetic retinopathy is a common condition, affecting one in three diabetic patients seen in ophthalmology consultations. Factors associated with diabetic retinopathy include poor glycemic control, the duration of diabetes and hypertension. Renal insufficiency was the main factor in disease progression. Therefore, there is a need to raise awareness among the general population, diabetics in particular and healthcare professionals to improve the management of risk factors.

Conflict of Interest

The author declares no potential conflicts of interest with respect to the research, authorship and/or publication of this article.

Funding Details

No funding was received for this review.

Author’s Contributions

All authors have contributed equally to this work and have reviewed and approved the final manuscript for publication.

Consent For Publication

Not applicable.

Ethical Statement

Not Applicable.

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