Aim: Data on glaucoma and cataract in Afro-Caribbean youth with diabetes are scarce. We sought to determine the prevalence of ocular complications and their risk factors in a group of Haitian youth with diabetes.
Methods: A cross-sectional study was conducted on youth aged 0-25 years with insulin-treated diabetes from one diabetes clinic in Haiti. We performed on both eyes visual acuity, Ishihara test, tonometry by Goldmann applanation, corneal pachymetry, slit lamp, refraction, gonioscopy, dilated fundoscopy and retinography, Humphrey visual field (VF), and spectral domain optical coherence tomography (Cirrus SD-OCT). We carried out Michigan Neuropathy Screening Instrument and neurothesiometer tests, and measured hemoglobin A1c (HbA1c), fasting lipid profile, and spot urinary albumin-to-creatinine ratio (UACR) twice 6 weeks apart. Primary open-angle glaucoma (POAG) was based on characteristic changes in: 1- optic disc, 2- retinal nerve fiber layer/combined macular ganglion cell and inner plexiform layers, 3- VF. Possible, suspected and overt POAG were diagnosed in the presence of 1, ≥ 2 and ≥ 2 criteria plus visual acuity loss, respectively.
Results: We enrolled 51 patients: Age 18.4 ± 4.7 y, male 52.9%, diabetes duration 5.0 ± 3.2 y, HbA1c 11.2 ± 2.9%, normal lipid profile. Background diabetic retinopathy (DR), cataract, diabetic peripheral neuropathy, and increased UACR were found in 2.0%, 13.7%, 29.4%, and 7.8%, respectively. No color vision impairment was detected. Intraocular pressure was 17.3 ± 3.7 (R) and 17.1 ± 2.8 (L) mmHg. Ocular hypertension was found in 5.9%. POAG was overt in 3.9% and suspected in 17.7%. On regression analyses, none of the studied variables predicted POAG or cataract.
Conclusion: POAG and cataract are common and precocious in Haitian youth with diabetes, without detectable risk factors. DR is uncommon. Comprehensive eye examination with VF and OCT when available is suggested early after diabetes diagnosis.
E. Jean Baptiste: None. P. Larco: None. M. Charles Larco: None. J.E. von Oettingen: None. F. Rocourt: None. B. Hudicourt: None. K. Moise: None. R. Paul: None. R. Charles: None.