Evidence mapPaperPMID 27406115Full record

ArticleOphthalmology2016

First Prospective Cohort Study of Diabetic Retinopathy from Sub-Saharan Africa: High Incidence and Progression of Retinopathy and Relationship to Human Immunodeficiency Virus Infection.

Philip I Burgess, Simon P Harding, Marta García-Fiñana, Nicholas A V Beare, Gerald Msukwa, Theresa J Allain

Open access · hybridAbstract read
In one paragraph

Article in Ophthalmology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
2.4field-weighted citation impact, top 12% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 14 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 5 institutions in 2 countries.

Philip I BurgessMalawi-Liverpool-Wellcome Trust Clinical Research Programme, and Department of Eye and Vision Science, University of Liverpool, Liverpool, England. Electronic address: philipburgess@doctors.org.uk.
Simon P HardingDepartment of Eye and Vision Science, University of Liverpool, and St. Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, England.
Marta García-FiñanaDepartment of Biostatistics, University of Liverpool, Liverpool, England.
Nicholas A V BeareSt. Paul's Eye Unit, Royal Liverpool University Hospital, and Department of Eye and Vision Science, University of Liverpool, Liverpool, England.
Gerald MsukwaLions Sight First Eye Unit, Queen Elizabeth Central Hospital, Blantyre, Malawi.
Theresa J AllainCollege of Medicine, University of Malawi, Blantyre, Malawi.
University of Liverpool · GBMalawi-Liverpool-Wellcome Trust Clinical Research Programme · MWQueen Elizabeth Central Hospital · MWRoyal Liverpool University Hospital · GBUniversity of Malawi · MW

Funding

Wellcome TrustWellcome Trust 094015/Z/10/A
6 · The paper itself

Abstract

purposeTo describe the prevalence, incidence, and progression of retinopathy and to report associations with demographic, clinical, and biochemical variables in people with diabetes in Southern Malawi.

designProspective cohort study.

participantsSubjects were systematically sampled from 2 primary care diabetes clinics.

methodsWe performed the first prospective cohort study of diabetic retinopathy from Sub-Saharan Africa over 24 months. Visual acuity, glycemic control, blood pressure, human immunodeficiency virus (HIV) status, urine albumin-to-creatinine ratio, hemoglobin, and lipids were assessed. Retinopathy was graded at an accredited reading center using modified Wisconsin grading of 4-field mydriatic photographs.

main outcome measuresIncidence of sight-threatening retinopathy and progression of retinopathy by 2 steps on the Liverpool Diabetic Eye Study Scale.

resultsA total of 357 subjects were recruited to the 24-month cohort study. At baseline, 13.4% of subjects were HIV positive and 15.1% were anemic. The 2-year incidence of sight-threatening diabetic retinopathy (STDR) for subjects with level 10 (no retinopathy), level 20 (background), and level 30 (preproliferative) retinopathy at baseline was 2.7% (95% confidence interval [CI], 0.1-5.3), 27.3% (95% CI, 16.4-38.2), and 25.0% (95% CI, 0-67.4), respectively. In a multivariate logistic analysis, 2-step progression of diabetic retinopathy was associated with glycosylated hemoglobin (odds ratio [OR], 1.27; 95% CI, 1.12-1.45), baseline grade of retinopathy (OR, 1.39; 95% CI, 1.02-1.91), and HIV infection (OR, 0.16; 95% CI, 0.03-0.78). At 2 years, 17 subjects (5.8%) lost ≥15 letters.

conclusionsIncidence of STDR was approximately 3 times that reported in recent European studies. The negative association of HIV infection with retinopathy progression is a new finding.

Indexed as

AdultAgedDiabetic RetinopathyDisease ProgressionFemaleGlycated HemoglobinHIV InfectionsHumansIncidenceMalawiMaleMiddle AgedMultivariate AnalysisPrevalenceProspective StudiesRisk FactorsGlycated Hemoglobin

Identifiers

PMID27406115
PMCPMC4994575
OpenAlexW2469267589

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.