Rapid assessment of avoidable blindness and diabetic retinopathy in Taif, Saudi Arabia
- 1Department of Ophthalmology, Faculty of Medicine, Taif University, Taif, Saudi Arabia
- 2International Agency of Prevention of Blindness, Riyadh, Saudi Arabia
- 3King Fahad Medical City, Riyadh, Saudi Arabia
- 4Tennent Institute of Ophthalmology, Glasgow, UK
- 5Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK
- Correspondence to Hannah Kuper, Department of Clinical Research, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK;
Contributors SP and HK developed the survey protocol and wrote the paper. SP, AHAG, MR and SH undertook the fieldwork and examination of participants. DY provided expertise on DR assessment, and graded the fundus photographs.
- Accepted 13 June 2012
- Published Online First 11 July 2012
Background/aims To estimate the prevalence of blindness, diabetes and diabetic retinopathy (DR) in Taif, Saudi Arabia using the Rapid Assessment of Avoidable Blindness (RAAB) framework.
Methods 66 clusters of 50 people aged ≥50 years were randomly selected. Participants underwent visual acuity measurement and examination by an ophthalmologist. DR among diabetic participants (previous diagnosis and/or random blood glucose >200 mg/dl) was assessed through dilated fundus examination by an ophthalmologist using a direct and indirect ophthalmoscope (‘clinical examination’) and dilated digital fundus photographs graded by a retinal specialist following the Scottish DR grading system (‘reference standard’).
Results 3052 (93%) out of 3300 eligible people were examined. The prevalence of blindness was 2.6% (95% CI 2.0% to 3.2%). Posterior segment diseases (44%) and cataract (41%) were the leading causes of blindness. The estimated prevalence of diabetes was 29.7% (28.1% to 31.4%), among whom the prevalence of DR was 36.8% (33.3% to 40.2%) and sight-threatening DR (STDR) was 17.5% (CI 15.1% to 20.0%). Agreement was good (κ>0.6) between the clinical examination and reference standard for any DR and STDR.
Conclusions There was a high prevalence of diabetes, DR and STDR. It was possible to assess diabetes and DR within RAAB but it increased the survey duration, cost and complexity.
Funding This study was supported with funding from Fight for Sight (grant number 1765) and International Agency for the Prevention of Blindness, Eastern Mediterranean region (IAPB, EMRO).
Competing interests None.
Patient consent Obtained.
Ethics approval LSHTM.
Provenance and peer review Not commissioned; externally peer reviewed.