An Epidemiological Study of Diabetic Cataract in Scotland based on Electronic Health Record (GoDARTS dataset)

Abstract

Background: As the leading cause of global blindness and visual impairment (VI) by World Health Organization in 2010, cataract has been becoming a substantial public health problem all over the world accounting for almost 40 million blind people in developed and developing countries. Cataract-related VI and other VI are becoming one of the biggest economic burdens in prevention and treatment. Among all risk factors for cataract, diabetes is one of the most significant ones and the population of diabetic patient is growing. There is few recent cataract epidemiology study which focus on diabetic population especially in developed countries.

Aim: To provide a brief report of prevalence of cataract in diabetic population and explore risk factors of diabetic cataract in a Scottish health board area.

Method: The data of 3279 diabetic subjects in this cross-sectional study were collected from The Genetics of Diabetes Audit and Research Tayside (GoDARTS) project. All data collected from participants are anonymously linked to their electronic health records with consent. Health records are from the Scottish Care Information-Diabetes Collaboration (SCI-DC) database and NHS database.

Results: The prevalence of diabetic cataract was 38.2% (95% confidence interval [CI], 36.5-39.9), and the age adjusted prevalence was down to 24% (95% CI, 22.5-25.5). Prevalence was higher for women than men (40.8% vs. 36.0%, Relative Risk [RR] =1.13, 95% CI 1.04-1.24), and higher for those with shorter duration of diabetes (less than 10 years) than those with longer duration (49.7% vs. 37.5%, RR=1.33, 95% CI, 1.14-1.54). The risk factors for any cataract were older age (years, Odds Ratio [OR] =1.080, 95% CI, 1.070-1.090), longer duration of diabetes (years, OR=1.033, 95% CI, 1.032-1.053), being in a richer family than the most deprived ones (OR, 1.306 for deprived group, 1.897 for middle, 1.718 for affluent group). For biochemistry factors, albuminuria ≥20 mg/L (OR=1.273, 95% CI, 1.077-1.504), higher serum low-density lipoprotein ([LDL], OR=1.440 for 2.03-2.50 mmol/L, OR=1.493 for >2.50 mmol/L). For protective factors, being a female (OR=0.816, 95% CI, 0.689-0.967), higher systole blood pressure (OR=0.991, 95% CI, 0.986-0.996), higher total serum cholesterol (OR=0.650 for 4.12-4.66 mmol/L, OR=0.624 for >4.66 mmol/L).

Conclusions: Nearly one fourth of the studied diabetic population had cataract, and there are neither evident risk factors nor protective factors for cataract in diabetic subjects that were inconsistent with factors for cataract in general population.

Date of Award	2016
Original language	English
Awarding Institution	University of Dundee
Supervisor	Weihua Meng (Supervisor), Fiona Williams (Supervisor) & Helen Looker (Supervisor)