Original title: New insight into diabetic eye disease

Indian Singaporeans with diabetes have a higher chance of developing diabetic eye disease and vision loss compared with their Chinese and Malay counterparts, a local study has found.

This was even after accounting for risk factors for the disease, such as how well patients controlled their blood sugar level and blood pressure, and how long they have had diabetes for.

Researchers studied the retinal photographs of 2,877 diabetic patients aged 40 and above from the three ethnic groups, from 2004 to 2011.

The study was led by researchers from the Singapore National Eye Centre (SNEC) and Singapore Eye Research Institute (Seri).

They found that 30.7 per cent of Indian Singaporeans have diabetic retinopathy – a condition in which damaged blood vessels in the retina cause vision loss – compared with 26.2 per cent of Chinese and 25.5 per cent of Malays.

The prevalence of diabetic macular oedema – a progression from diabetic retinopathy – was also highest for Indian Singaporeans, at 9.5 per cent. In comparison, 6.1 per cent of Chinese and 5.7 per cent of Malays have the condition.

Diabetic macular oedema occurs when the damaged blood vessels leak fluid into the retina, causing both the centre of the retina and its surrounding tissue to swell.

With the risk factors for diabetic retinopathy being similar for the three ethnic groups, the difference in prevalence could be due partly to genetics, though researchers have not yet identified any gene responsible for it, said Dr Gavin Tan, the lead researcher and consultant ophthalmologist with SNEC’s surgical retina department.

Environmental factors such as diet and lifestyle diseases could also be contributing factors as they were not measured in the study, he added.

“This suggests that public health resources targeted at addressing the eye complications of diabetes in this group (Indian Singaporeans) may have a greater impact,” he said.

Mr Jayagomar Govindarajoo’s careful monitoring of his diabetes enabled him to treat his diabetic macular oedema in time.

“I had blurred vision and there was a lot of water coming out (of my right eye),” said the general manager of a shipping company, 62, whose condition was spotted at a regular eye check-up in 2015.

His eye condition has now stabilised, after he received laser treatment and eye injections starting in August 2015. “I still must go for my periodical eye check-ups,” said Mr Govindarajoo, who has had diabetes for 15 years.

The study was published in Ophthalmology, the journal of the American Academy of Ophthalmology, last December. It is part of a larger study on eye diseases in Singapore, called the Singapore Epidemiology of Eye Diseases Study.

More than 400,000 Singaporeans have diabetes, and one in three also has diabetic retinopathy. The SNEC sees 28,000 patients with diabetic retinopathy each year.

With the study’s findings, Dr Tan hopes that more diabetic patients will be aware of and educated about diabetic eye diseases.

“Patients with diabetes are often asymptomatic (showing no symptoms), therefore, it is difficult for them to understand how good glucose control now will prevent complications, such as diabetic eye disease and diabetic kidney disease, which will only occur years later,” he said.

“Screening for diabetic eye disease will allow us to pick it up at an asymptomatic stage, where early treatment can prevent vision loss.”

Patients can be screened through the Singapore Integrated Diabetic Retinopathy Programme at polyclinics and GP clinics.

Each screening costs $8 to $12 with subsidies, and $25 to $30 without subsidies at polyclinics.