Global Prevalence and Major Risk Factors of Diabetic Retinopathy
Top Cited Papers
Open Access
- 10 February 2012
- journal article
- review article
- Published by American Diabetes Association in Diabetes Care
- Vol. 35 (3), 556-564
- https://doi.org/10.2337/dc11-1909
Abstract
OBJECTIVE: To examine the global prevalence and major risk factors for diabetic retinopathy (DR) and vision-threatening diabetic retinopathy (VTDR) among people with diabetes. RESEARCH DESIGN AND METHODS: A pooled analysis using individual participant data from population-based studies around the world was performed. A systematic literature review was conducted to identify all population-based studies in general populations or individuals with diabetes who had ascertained DR from retinal photographs. Studies provided data for DR end points, including any DR, proliferative DR, diabetic macular edema, and VTDR, and also major systemic risk factors. Pooled prevalence estimates were directly age-standardized to the 2010 World Diabetes Population aged 20–79 years. RESULTS: A total of 35 studies (1980–2008) provided data from 22,896 individuals with diabetes. The overall prevalence was 34.6% (95% CI 34.5–34.8) for any DR, 6.96% (6.87–7.04) for proliferative DR, 6.81% (6.74–6.89) for diabetic macular edema, and 10.2% (10.1–10.3) for VTDR. All DR prevalence end points increased with diabetes duration, hemoglobin A1c, and blood pressure levels and were higher in people with type 1 compared with type 2 diabetes. CONCLUSIONS: There are approximately 93 million people with DR, 17 million with proliferative DR, 21 million with diabetic macular edema, and 28 million with VTDR worldwide. Longer diabetes duration and poorer glycemic and blood pressure control are strongly associated with DR. These data highlight the substantial worldwide public health burden of DR and the importance of modifiable risk factors in its occurrence. This study is limited by data pooled from studies at different time points, with different methodologies and population characteristics.Keywords
This publication has 35 references indexed in Scilit:
- Prevalence of Diabetic Retinopathy in the United States, 2005-2008JAMA, 2010
- Prevalence of Diabetes among Men and Women in ChinaThe New England Journal of Medicine, 2010
- Rates of Progression in Diabetic Retinopathy During Different Time PeriodsDiabetes Care, 2009
- The Role of Genetics in Susceptibility to Diabetic RetinopathyInternational Ophthalmology Clinics, 2009
- Prevalence and Risk Factors for Diabetic Retinopathy: The Singapore Malay Eye StudyOphthalmology, 2008
- Intensive Blood Glucose Control and Vascular Outcomes in Patients with Type 2 DiabetesThe New England Journal of Medicine, 2008
- Overview of Epidemiologic Studies of Diabetic RetinopathyOphthalmic Epidemiology, 2007
- Diabetic retinopathy in Victoria, Australia: the Visual Impairment ProjectBritish Journal of Ophthalmology, 2000
- Racial Differences in the Relationship Between Blood Pressure and Risk of Retinopathy Among Individuals With NIDDMDiabetes Care, 1993
- Is there an ethnic difference in the effect of risk factors for diabetic retinopathy?Annals of Epidemiology, 1993