Global prevalence and major risk factors of diabetic retinopathy

Yau JWY, Rogers SL, Kawasaki R, et al; on behalf of the Meta-Analysis for Eye Disease (META-EYE) Study Group. Diabetes Care. 2012; Epub ahead of print. 
Diabetes Care. 2012; Epub ahead of print. 

This overview was created under the auspices of KnowledgePoint360 Group, LLC, and was not associated with funding via an educational grant or a promotional interest. 

Yau and colleagues performed a pooled analysis using individual subject data from 35 studies conducted worldwide to assess the prevalence of diabetic retinopathy (DR) and sight-threatening conditions. 

Subjects (N=22,896) were from the United States, Australia, Europe, and Asia. The majority of subjects were female (52%) and Caucasian (44.4%). Mean age was 58.1 years and median diabetes duration and A1C were 7.9 years and 8.0%, respectively. 

Retinal photography was performed in all studies; DR was graded by the Early Treatment Diabetic Retinopathy Scale and its modification or the American Academy of Ophthalmology International Clinical Diabetic Retinopathy Disease Severity Scale. The assessment of outcomes was based on severity in the worse eye or the single eye that was photographed. 

Prevalence of conditions was as follows: 

  • DR: 34.6% (95% confidence interval [CI], 34.5–34.8); 92.6 million (95% CI, 91.2–94.0) 
  • Proliferative DR: 6.96% (95% CI, 6.87–7.04); 17.2 million (95% CI, 16.6–17.7) 
  • Diabetic macular edema: 6.81% (95% CI, 6.74–6.89); 20.6 million (95% CI, 19.6–21.6) 
  • Vision-threatening DR: 10.2% (95% CI, 10.1–10.3); 28.4 million (95% CI, 27.6–29.2) 

Additional results: 

  • Lowest prevalence of DR was seen among Asian subjects; highest prevalence was seen among African American subjects 
  • Prevalence of any DR was higher in those with type 1 compared with those with type 2 diabetes (77.3% vs 25.2%, respectively); prevalence increased with: 
    • A1C (≤7.0% vs >9.0%: 18.0% vs 51.2%) 
    • Blood pressure (≤140/90 mm Hg vs >140/90 mm Hg: 30.8% vs 39.6%) 
    • Diabetes duration (<10 years vs ≥20 years: 21.1% vs 76.3%) 
     
  • Similar relationships, prevalence was seen for proliferative DR, diabetic macular edema, and vision-threatening DR 
  • VisionAfter risk factor adjustment, subjects with type 1 diabetes for ≥20 years more likely to have DR, proliferative DR, diabetic macular edema, and vision-threatening DR compared with those with type 2 diabetes for <10 years 

This overview was created under the auspices of KnowledgePoint360 Group, LLC, and was not associated with funding via an educational grant or a promotional interest. 

 

Last Modified: 1/16/2013