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Global prevalence and major risk factors of diabetic retinopathy.

TitleGlobal prevalence and major risk factors of diabetic retinopathy.
Publication TypeJournal Article
Year of Publication2012
AuthorsW Y Yau J, Rogers SL, Kawasaki R, Lamoureux EL, Kowalski JW, Bek T, Chen S-J, Dekker JM, Fletcher A, Grauslund J, Haffner S, Hamman RF, M Ikram K, Kayama T, Klein BEK, 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 J J, Wang N, West S, Xu L, Yasuda M, Zhang X, Mitchell P, Wong TY
Corporate AuthorsMeta-Analysis for Eye Disease(META-EYE) Study Group
JournalDiabetes Care
Date Published2012 Mar
KeywordsAdult, Aged, Blood Glucose, Blood Pressure, Diabetic Retinopathy, Female, Humans, Male, Middle Aged, Prevalence, Risk Factors, Young Adult

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 A(1c), 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.

Alternate JournalDiabetes Care
PubMed ID22301125
PubMed Central IDPMC3322721
Grant ListR01 EY016379 / EY / NEI NIH HHS / United States
U10 EY006594 / EY / NEI NIH HHS / United States
R01-EY-09860 / EY / NEI NIH HHS / United States
R01 EY009860 / EY / NEI NIH HHS / United States
EY-06594 / EY / NEI NIH HHS / United States