Introduction Diabetic retinopathy (DR) remains a prevalent cause of preventable blindness and one of the most serious complications of diabetes mellitus globally, which can be minimized by periodic screening and risk factor management. Nonetheless, few studies have assessed its prevalence and predictors among diabetic patients in primary care settings. This study aimed to determine the prevalence and predictors of DR among diabetic patients in primary care in Bahrain. Methods A cross-sectional study was conducted in October-November 2025 across all primary healthcare centers in Bahrain. All adult patients with diabetes attending diabetic clinics were included. DR was assessed by a specialist optometrist using a non-mydriatic retinal camera (TOPCON NW500). Retina assessment results included normal retina, non-proliferative retinopathy and proliferative retinopathy. Sociodemographic characteristics, comorbidities, and risk factors were collected. Descriptive and inferential analyses were done. A P-value <0.05 was considered statistically significant. Results A total of 594 patients were included, with a median age of 61 years. Most participants were male (337, 56.7%), Bahraini (506, 85.2%), and had type 2 diabetes (575, 96.8%). Dyslipidemia (463, 77.9%) and hypertension (397, 66.8%) were the commonest comorbidities. DR was noted in 88 (14.8%) patients; 13% (n=77) had non-proliferative DR and 1.8% (n=11) had proliferative DR. Univariate analysis showed that patients with retinopathy were older (P<0.001), had a longer diabetes duration (P<0.001), and higher rates of hypertension (P=0.001), dyslipidemia (P=0.009), chronic kidney disease (P<0.001), and ischemic heart disease (P=0.042). Additionally, higher glycated hemoglobin (P=0.014), and triglycerides (P=0.022), and lower glomerular filtration rate (P<0.001) were found among patients with retinopathy. Logistic regression identified a longer diabetes duration (OR=1.576, P<0.001), hypertension (OR=1.912, P=0.039), abnormal monofilament test (OR=2.92, P=0.027), and higher HbA1c (OR=1.013, P=0.033) as predictors of DR. Conclusion DR affects one in seven diabetic patients attending primary care in Bahrain, particularly those with a longer disease duration, hypertension, poor glycemic control, and neuropathy. Annual retinal screening, optimal glycemic control, and risk factor management by primary care professionals are essential to reduce its sequelae.
Alawainati et al. (Sat,) studied this question.