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, 21million with diabetic macular edema, and 28million 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.

Global Prevalence and Major Risk Factors of Diabetic Retinopathy

PORTA, Massimo;PANERO, FRANCESCO;BRUNO, Graziella;
2012

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, 21million with diabetic macular edema, and 28million 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.
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Yau JW; Rogers SL; Kawasaki R; Lamoureux EL; Kowalski JW; Bek T; Chen SJ; Dekker JM; Fletcher A; Grauslund J; Haffner S; Hamman RF; Ikram MK; Kayama T; Klein BE; Klein R; Krishnaiah S; Mayurasakorn K; O'Hare JP; Orchard TJ; Porta M; Rema M; Roy MS; Sharma T; Shaw J; Taylor H; Tielsch JM; Varma R; Wang JJ; Wang N; West S; Xu L; Yasuda M; Zhang X; Mitchell P; Wong TY; Yau JW; Rogers SL; Kawasaki R; Lamoureux EL; Wong TY; Kowalski JW; Mahabhashyam S; Yeh WS; Aung T; Saw SM; Tay W; Wong W; Panero F; Porta M; Bruno G; Caengow S; Somthip N; Chuikarat N; Wanichsuwan M; Mayurasakorn K; Chen SJ; Cheng CY; Chou P; Hsu WM; Liu JH; Chakravarthy U; Cotch MF; Vingerling J; De Jong P; Ikram M; Zavrelova H; Nijpels G; Dekker JM; Fletcher A; Grauslund J; Sjølie AK; Bek T; Stern M; Haffner S; Hamman RF; Yasuda M; Ishibashi T; Kiyohara Y; Jensen RA; Jonas JB; Kato T; Yamashita H; Kayama T; Munoz B; Katz J; West S; Tielsch JM; Friedman D; Klein R; Klein BE; Krishnaiah S; Lehman DM; McCarty C; Miller RG; Orchard T; Pradeepa R; Mohan R; Mohan V; O'Hare JP; Raymond NT; Polak BC; Wang JJ; Mitchell P; Rochtchina E; Roy MS; Raman R; Sharma T; Torres M; Varma R; Seland J; Vioque J; Wang FH; Wang NL; Liang YB; You QS; Xu L; Zhang XY; Wang YX; Young I; Zhang X; Taylor HR; Siscovick DS; Stehouwer CD; Rahu M; Soubrane G; Tomazzoli L; Topouzis F; Shaw J; Zimmet P.
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