DIABETIC RETINOPATHY IN FILIPINOS

Operation Silip Mata (Eye Screening Among Diabetics) was launched in 1996 for the diabetes complication screening program of the diabetes awareness program of the Diabetes Center. This project was carried out jointly with Philippine Academy of Opthalmology, Philippine Diabetes Association and Zuellig Pharma Corporation.

In the years 1996 - 1998, a total of 1269 diabetics from 45 hospitals and diabetes clinics nationwide were screened by opthalmologists for cataract and diabetic retinopathy using fundoscopic examination. Other pertinent patient information were obtained such as duration of diabetes, family history of diabetes, blood pressure, visual acuity medications, age, sex and civil status. The main objectives of the study were to determine incidence of diabetic retinopathy among Filipino diabetics, to correlate duration of diabetes with retinopathy and to determine differences in incidence of diabetic retinopathy in geographical regions.

Only 1187 patient records were completed and thus included in the analysis. The patients screened were distributed as follows: Metro Manila/NCR - 630 patients, Luzon (other than NCR) - 137 patients, Visayas - 286 patients, Mindanao - 154 patients.


Limitations of the Study:

Sampling was not randomized and equally distributed by regions; thus, the study population may not be truly representative of the total diabetic population in the Philippines. Findings of the study should therefore be considered as indicative and not conclusive.

Results:

Based on fundoscopic tests, 49% had abnormal eye findings; 28% with diabetic retinopathy (DR); and 28% with cataract. Out of 28% with DR 22% were in the background stage. 6% were in preproliferative and proliferative stages.

The incidence of DR is significantly higher in Metro Manila (NCR) 34% compared to Luzon (other than NCR) at 24%; Visayas at 19% and Mindanao at 21%. Majority of DR cases (64%) were found in Metro Manila. Duration of diabetes, age and insulin treatment correlated positively with incidence of DR. The average age of patients of DR was 58 years vs. 56 years for those without DR. The duration of DM was 8.5 years for those with DR vs 5.5 years for those without DR. 16% of those with DR were on insulin vs. 8% in those without DR. Sex, family history and hypertension did not show any correlation with DR in the study.

The incidence of cataract (28%) was similar for the incidence of DR (28%) but was not significantly correlated with DR. Only 9% of diabetics had cataract and DR, which means that a greater portion (18%-19%) had either cataract or DR but not both.


Acknowledgements:

We would like to recognize the invaluable help of all the people who contributed to this study: Henry Pineda of Zuellig Pharma, the doctors of the different diabetes clinics who participated in the screening, Medical Bureau of Diabetes Center, Susan Trinidad of Diabetes Center and many others whose names cannot all be listed.