International Journal of Retina (IJRETINA) 2025.
Volume 8.
Number 1.
P-ISSN.
E-ISSN.
PREVALENCE AND DEMOGRAPHIC PATTERNS OF DIABETIC RETINOPATHY,
RETINAL VEIN OCCLUSION.
AND AGE-RELATED MACULAR DEGENERATION IN
EASTERN INDIA: AN EPIDEMIOLOGICAL STUDY.
Bibhuti Prassan Sinha.
Abhishek Anand.
Shivani Sinh.
Nishita Yadav.
Aniket Kumar Institute of Ophthalmology.
Indira Gandhi Institute of Medical Sciences.
Patna 800014.
Bihar.
India.
Abstract Introduction: To elucidate the epidemiology, clinical characteristics, and treatment outcomes of retinal diseases in Eastern India.
Methods: This prospective observational study was conducted at a tertiary care hospital from August 2021 to December 2022.
Adult patients (Ou18 year.
diagnosed with diabetic retinopathy (DR), retinal vein occlusion (RVO), or age-related macular degeneration (ARMD) were enrolled after obtaining informed consent.
Comprehensive data collection, including demographic information, clinical characteristics, and treatment outcomes, was conducted.
Data were analyzed using descriptive and inferential statistical methods.
Results: The study cohort (N=.
exhibited a predominance of DR .
84%, 95% CI: 57.
2%),
followed by branch retinal vein occlusion (BRVO, 18.
72%, 95% CI: 16.
6%).
ARMD .
07%, 95%
CI: 10.
5%), and central retinal vein occlusion (CRVO, 11.
08%, 95% CI: 9.
4%).
Demographic analysis revealed a male predominance .
65%, 95% CI: 70.
6%) and a younger population .
3% O60 years, 95% CI: 56.
6%).
Comorbidities were highly prevalent, with diabetes mellitus .
83%, 95% CI: 66.
9%) and hypertension .
99%, 95% CI: 55.
3%) being the most Clinical evaluation showed decreased vision as the primary symptom .
17%, 95% CI:
1%).
Best Corrected Visual Acuity (BCVA) of 0.
5 or better was observed in 52.
1% of patients .
% CI: 48.
5%).
Optical Coherence Tomography revealed Central Macular Thickness exceeding 300 AAm in 34.
62% of cases .
% CI: 31.
9%).
Laser therapy was the predominant treatment modality .
13%, 95% CI: 9.
4%).
Follow-up adherence demonstrated a significant decline after the initial visit .
13% to 16.
77%, p<0.
Conclusion: This study highlights the urgent need for enhanced screening protocols and multidisciplinary management strategies in Eastern India to address the high burden of retinal Targeted interventions in this region could prevent vision loss and improve healthcare Keywords: Retinal disease.
Comorbidities.
Management.
Eastern India Cite This Article: SINHA.
Bibhuti Prassan et al.
Prevalence and Demographic Patterns of Diabetic Retinopathy.
Retinal Vein Occlusion, and AgeRelated Macular Degeneration in Eastern India: An Epidemiological Study.
International Journal of Retina, [S.
ISSN
Available <https://w.
com/index.
php/ijretina/article/view/307>.
Date accessed: 04 mar.
doi: https://doi.
org/10.
35479/ijretina.
Published by: INAVRS https://w.
org/ | International Journal of Retina https://ijretina.
significant value given the holistic nature of the INTRODUCTION Retinal diseases including patientsAo health .
Moreover, there was the need to Aniket Kumar.
Indira Gandhi Institute of Medical Sciences Bihar.
India.
DR.
BRVO.
CRVO, and ARMD assess the success rates of the various treatment have significantly contributed modalities such as laser therapy and vitrectomy and to visual impairment and bioinfo@gmail.
the rates of improvement in visual acuity as well as the progression of the disease in order to enhance Globally, diabetic retinopathy cliniciansAo use of these treatment interventions to had been identified as a major cause of vision loss accomplish the best outcomes for their patients .
, among working-age adults, affecting nearly one- Correspondence to:
third of individuals with diabetes mellitus .
This non-proliferative proliferative statuses and was accompanied by such complications as macular edema and vitreous hemorrhage .
Likewise, in BRVO and CRVO, which were previously reported to be associated with systemic diseases like hypertension and diabetes.
While the global burden of retinal diseases is welldocumented, limited epidemiological data exists for Eastern India, a region with unique socio-economic challenges and barriers to healthcare.
This study aims to fill this gap by analyzing the prevalence and demographic patterns of retinal diseases in this underserved region.
manifesting in the form of retinal ischemia and METHODS macular edema .
, .
Wet age-related macular Study Design and Setting: This prospective and degeneration was identified as one of the main cross sectional study was conducted at a tertiary causes of central vision loss in elderly population as care hospital serving the eastern part of India.
The the rates of the disease grew with the advancement study period spanned from August 2021 to of age .
December 2022.
The study protocol was approved The prevalence of these retinal diseases in India had been made worse by incidences of diabetes as well as aging.
The country was confronted to massive cast of diabetic retinopathy following several millions people with diabetes mellitus in the world .
Moreover.
BRVO and CRVO had been considered significant due to the rising rate of hypertension and diabetes among the Indian adult population .
ARMD also translate to becoming a major problem because of the enhancement of life and altered lifestyles .
/IEC/IGIMS/2.
, and the research adhered to the tenets of the Declaration of Helsinki.
Patient Selection and Sampling: Adult patients (Ou18 year.
diagnosed with DR.
RVO (BRVO or CRVO), or ARMD who visited the outpatient and special clinics of the ophthalmology department were eligible for inclusion.
Individuals who declined participation were excluded.
The diagnosis was confirmed by a consultant ophthalmologist based on comprehensive ophthalmic examination and Among the comorbidities that had also affected imaging studies.
We employed a consecutive the clinical features and the management of retinal sampling method, enrolling all eligible patients who diseases were diabetes mellitus (DM), hypertension provided written informed consent during the study (HTN) and cardiovascular diseases (CAD).
Recording This study adhered to the tenets of the these co morbidities and their effect on ocular Declaration of Helsinki.
symptoms like vision acuity and pain was of Published by: INAVRS https://w.
org/ | International Journal of Retina https://ijretina.
Data Collection: After obtaining written informed as means with standard deviations or medians with interquartile ranges, depending on the distribution demographic data, anthropometric measurements, of data.
Categorical variables were presented as and medical history using standardized case report frequencies and percentages.
Confidence intervals forms (CRF.
The following information was .
% CI) were computed for key percentages using recorded: demographic data .
ender and se.
, the Wilson score method.
Chi-square tests were used to compare proportions between groups, with BCVA a significance level set at p<0.
Trends in follow- measurement using a Snellen chart, converted to up adherence were analyzed using the Cochran- logMAR for analysis, slit-lamp and examination.
Armitage test for trend.
ophthalmoscopy and slit-lamp biomicroscopy with a 90D lens.
Ocular Imaging using: Color fundus photography was performed using a Topcon TRC50DX retinal camera (Topcon Corporation.
Tokyo.
Japa.
Optical Coherence Tomography (OCT) was performed Topcon Corporation.
Tokyo.
Japan.
Central macular thickness (CMT) and central subfield
thickness (CSFT) were measured using the built-in
RESULTS
Prevalence and Distribution of Retinal Diseases A total of 812 subjects were enrolled in the study between August 2021 and December 2022.
DR was the most prevalent retinal disease, affecting 494 individuals .
84%, 95% CI: 57.
2%).
BRVO was the second most common condition, observed in 152 patients .
72%, 95% CI: 16.
6%).
CRVO
was present in 90 cases .
08%, 95% CI: 9.
4%),
while ARMD was noted in 98 patients .
07%, 95%
Treatment and Follow-up: Treatment decisions CI: 10.
5%) as shown in table 1.
were made by the treating ophthalmologist based Demographic Factors on current clinical guidelines.
Treatment modalities The demographic analysis indicated a substantial gender imbalance, with males comprising 73.
65% of injections, and vitrectomy.
Patients were followed up at 3, 6, and 12 months post-treatment, or more compared to 26.
35% females .
% CI: 23.
5%).
frequently if clinically indicated.
Age distribution showed that 60.
3% of patients were Statistical analysis: Descriptive statistics were calculated using SPSS version 26.
0 (IBM Corp.
Armonk.
NY).
Continuous variables were presented .
% CI:
60 years of age or younger .
% CI: 56.
6%),
7% were older than 60 .
% CI: 36.
as shown in table 1.
Table 1: Statistical summary of Key Retinal Diseases and Demographics Category Retinal Diseases Gender
Age
Subcategory BRVO
CRVO
ARMD
Male Female O 60 years > 60 years Number of Patients Percentage 95% Confidence Interval 4% - 64.
1% - 21.
1% - 13.
0% - 14.
5% - 76.
4% - 29.
9% - 63.
4% - 43.
Published by: INAVRS https://w.
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Comorbidities Diabetes 6% - 19.
7%) of the patients.
Coronary Artery Disease was present in 7.
02% .
% CI: 5.
5% - 9.
comorbidity, affecting 69.
83% .
% CI: 66.
6% -
of patients, while 5.
67% .
% CI: 4.
3% - 7.
5%) had a 9%) of the study population.
This high prevalence history of stroke.
Dyslipidemia was observed in 61% .
% CI: 7.
8% - 11.
8%) of patients.
Thyroid- diabetes and retinal diseases, particularly diabetic related diseases affected 9.
11% .
% CI: 7.
3% -
The vast majority of diabetic patients 3%) of the study population.
Among patients with .
12%, 95% CI: 97.
9% - 99.
6%) had Type II diabetes, thyroid disorders, hypothyroidism was far more while only a small fraction .
88%, 95% CI: 0.
4% -
19%, 95% CI: 80.
1% - 94.
4%) than 1%) had Type I diabetes.
Hypertension was the hyperthyroidism .
81%, 95% CI: 5.
6% - 19.
9%).
second most common comorbidity, present in Strikingly, 86.
08% .
% CI: 83.
6% - 88.
3%) of patients 99% .
% CI: 55.
6% - 62.
3%) of patients.
Chronic had at least one comorbidity as shown in table 2 Kidney Disease was observed in 17.
00% .
% CI:
Table 2: Prevalence of Comorbidities among Patients with Retinal Diseases in Eastern India
Comorbidity Diabetes Mellitus
Type II Diabetes Type I Diabetes Hypertension CAD
CKD
Dyslipidemia Stroke Thyroid Related Disease Hypothyroidism Hyperthyroidism At least One Comorbidity Number of Patients Percentage (%) 95% CI 6% - 72.
9% - 99.
4% - 2.
6% - 62.
5% - 9.
6% - 19.
8% - 11.
3% - 7.
3% - 11.
1% - 94.
6% - 19.
6% - 88.
Ocular History and Symptoms The symptom profile revealed that decreased vision was the most frequently reported issue, affecting 9% of patients.
Other symptoms were less common, with watering in only 4.
2%, redness 0.
and flashes in 0.
8% of cases.
Floaters and pain 5% and 3.
4% of patients, respectively.
Symptoms such as photophobia, redness, scotomas, and watering were observed in a small proportion of the cohort, indicating a range of ocular symptoms with decreased vision being the most prevalent concern as shown in figure 1.
Figure 1: Ocular History and Symptoms Published by: INAVRS https://w.
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Clinical Characteristics and Biomarkers Clinical Best .
5%).
Follow-up indicated that 55.
9% of patients attended the first Corrected Visual Acuity (BCVA), showed that 52.
follow-up of patients had a BCVA of 0.
5 or better, suggesting decreased in subsequent visits, with only 12.
relatively preserved vision in over half of the cohort.
A BCVA between 0.
5 and 1.
3 was observed in 29.
percentages for the third .
8%) and fourth .
of patients, while 18.
1% had a BCVA greater than 1.
This trend highlighted a need for improved OCT findings revealed that 53.
41% of patients had a follow-up adherence strategies as shown in figure 3.
the second follow-up and smaller CMT between 5-250 AAm, with 34.
62% exceeding 300 AAm.
CSFT data showed that 42.
15% of patients had AAm, significant variability in retinal thickness among patients as shown in figure 2.
Figure 3: Percentage of Treatment Modalities and Outcomes and follow-ups.
Patterns Trends Diagnosis Management Diagnosis and management patterns revealed that DR was frequently diagnosed in its moderate form .
45%), with severe and very severe cases being less common.
Branch Retinal Vein BRVO was Figure 2: Distribution of BCVA at baseline (A) and OCT biomarker (CMT & CSFT) B & C.
predominantly non-ischemic .
61%).
For CRVO, ischemic forms were most common .
56%).
ARMD
showed a predominance of wet AMD .
12%), with Treatment Modalities and Outcomes These patterns reflected the diversity Regarding treatment modalities, laser therapy was and complexity of retinal disease manifestations and the most commonly used intervention, applied in management as shown in figure 4 (A-D).
1% of cases.
Vitrectomy was utilized in a minimal Published by: INAVRS https://w.
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Figure 4: Patterns and Trends in Diagnosis and Management of DR (A).
BRVO (B).
CRVO (C) and ARMD (D).
Yau et al.
found that the global
DISCUSSION