Materiały źródłowe

• #1 VEHSS Modeled Estimates: Prevalence of Diabetic Retinopathy (DR) | Vision and Eye Health Surveillance System | CDC

  https://www.cdc.gov/vision-health-data/prevalence-estimates/dr-prevalence.html

  The Vision and Eye Health Surveillance System (VEHSS) modeled estimate of DR is CDCs primary estimate of the prevalence of DR in the United States. […] VEHSS researchers used a statistical method called Bayesian meta-regression to combine information from multiple data sources to produce DR prevalence estimates among the entire US population in 2021. […] In 2021 across all ages, an estimated 9.6 million people in the United States were living with diabetic retinopathy (DR). […] Of these, 1.84 million were living with vision-threatening DR. […] Among people with diabetes, the prevalence rate of DR was lowest among people younger than age 25 at 13.0% and highest among the 65-79 age group at 28.4%. […] Non-Hispanic blacks had the highest prevalence rate of DR (3.26%) and vision-threatening DR (1.11%).

• #1 Diabetic Retinopathy and Diabetic Eye Problems | Doctor

  https://patient.info/doctor/diabetic-retinopathy-and-diabetic-eye-problems

  Diabetes is the most common cause of severe sight impairment in working-age people in England, Wales and Scotland. […] Studies have shown that in people with diabetes aged between 20 and 79 years, the overall prevalence was 34.6% for any diabetic retinopathy (DR) and 7.0% for proliferative DR (PDR). The prevalence of any DR was higher in people with type 1 DM rather than type 2 DM (77.3% vs 25.2%, respectively). […] One study found that 37.4% of the people with type 1 diabetes had diabetic retinopathy at first screening, the risk being greater the longer the duration of diabetes or higher the HbA1c and diastolic blood pressure. […] In type 2 diabetes, these changes may be found at diagnosis because subclinical hyperglycaemia may have been present for a prolonged preceding period. Over 25 years, there is a significant cumulative rate of progression to diabetic retinopathy (83%), to diabetic macular oedema (29%) and to CSMO (17%).

• #1 Global Prevalence of Diabetic Retinopathy and Projection of Burden through 2045: Systematic Review and Meta-analysis – PubMed

  https://pubmed.ncbi.nlm.nih.gov/33940045/

  To provide updated estimates on the global prevalence and number of people with diabetic retinopathy (DR) through 2045. […] Diabetic retinopathy remains a common complication of DM and a leading cause of preventable blindness in the adult working population. […] Among individuals with diabetes, global prevalence was 22.27% (95% confidence interval [CI], 19.73%-25.03%) for DR, 6.17% (95% CI, 5.43%-6.98%) for VTDR, and 4.07% (95% CI, 3.42%-4.82%) for CSME. […] Diabetic retinopathy prevalence was highest in Africa (35.90%) and North American and the Caribbean (33.30%) and was lowest in South and Central America (13.37%). […] The global DR burden is expected to remain high through 2045, disproportionately affecting countries in the Middle East and North Africa and the Western Pacific. These updated estimates may guide DR screening, treatment, and public health care strategies.

• #1 Epidemiology of diabetic retinopathy, diabetic macular edema and related vision loss | Eye and Vision | Full Text

  https://eandv.biomedcentral.com/articles/10.1186/s40662-015-0026-2

  In general, patients with type 2 diabetes in Western communities have a higher prevalence of DR than their Asian counterparts. […] In the USA, studies estimate that 28.540.3 % of patients with type 2 diabetes had DR, and 4.48.2 % of them had VTDR. […] In the Middle-East, Saudi Arabia and Iran both report prevalence that are similar to Western communities (36.8 and 29.6 %, respectively). […] Although duration of diabetes is a major risk factor for DR, a few studies reported DR prevalence in newly diagnosed diabetes. […] There are few population-based cohort studies, outside of the USA or UK, which have investigated DR incidence. […] In the UK, population studies involving patients with type 2 diabetes estimated cumulative incidence of DR to be 26.0 % at 4 years. […] As with prevalence, incidence data from Asia is restricted only to that of type 2 diabetes.

• #1 Prevalence of diabetic retinopathy and vision-threatening diabetic retinopathy in adults with diabetes in China | Nature Communications

  https://www.nature.com/articles/s41467-023-39864-w

  The current epidemic status of diabetic retinopathy in China is unclear. A national prevalence survey of diabetic complications was conducted. The prevalence rates (95% confidence intervals) of diabetic retinopathy and vision-threatening diabetic retinopathy were 16.3% (15.3%17.2%) and 3.2% (2.9%3.5%), significantly higher in the northern than in the southern regions. […] In many countries, DR is a leading cause of preventable vision impairment and blindness in the working-age population. […] With the largest number of people with diabetes, around one-fourth of the global number, living in China, there is a lack of current data representing a national distribution of DR to guide the prevention and control strategy. […] Our study was the first to report a nationally representative prevalence of 16.3% (15.3%17.2%) for any DR and 3.2% (2.9%3.5%) for VTDR in Chinese adults with diagnosed diabetes aged 1874 years.

• #1 Changes in the Epidemiology of Diabetic Retinopathy in Spain: A Systematic Review and Meta-Analysis

  https://www.mdpi.com/2227-9032/10/7/1318

  In Spain, for T2DM, the current prevalence of DR is 15.28% and 1.92% for STDR. The annual incidence of DR is 3.83% and is 0.41% for STDR. […] The statistical analysis of those studies shows that the prevalence of DR has been decreasing over the years. Since 2008, the prevalence of DR has decreased from 28.85% to 15.28%. The cause of this decrease is linked to a greater diagnosis of patients with DM, especially from the year 2008; thus, in Figure 3 we observe an increase of 27.94% of patients with DM from 2001 to 2017. […] The annual incidence has been calculated based on the data extracted from the studies or from direct communication with the authors, considering the number of patients for whom DR is diagnosed with respect to the patients screened per year. The average annual incidence of DR found is 3.83% (CI 95% 1.93–5.73, minimum 2.01%—maximum 6.89%). The value of STDR incidence was 0.41% (CI 95% 0.27–0.55, minimum 0.39%—maximum 0.45%).

• #1 Epidemiology of diabetic retinopathy, diabetic macular edema and related vision loss

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4657234/

  Diabetic retinopathy (DR) is a leading cause of vision-loss globally. Of an estimated 285 million people with diabetes mellitus worldwide, approximately one third have signs of DR and of these, a further one third of DR is vision-threatening DR, including diabetic macular edema (DME). […] The most clinically important risk factors for progression to vision loss include duration of diabetes, hyperglycemia and hypertension. Control of serum glucose and blood pressure have been shown to be effective in preventing vision loss due to DR. […] Prevalence and risk factors of DR have been studied widely in previous studies including regional and ethnic differences, but epidemiological data on DME are relatively scarce. […] A pooled individual participant meta-analysis involving 35 studies conducted worldwide from 1980 to 2008, estimated global prevalence of any DR and PDR among patients with diabetes to be 35.4 and 7.5 % respectively.

• #1

  https://journals.lww.com/egos/fulltext/2024/17020/epidemiology_and_risk_factors_of_diabetic.13.aspx

  The significant risk factors for DR arranged descendingly in power were poor control of DM, longer duration of DM ( 15 years), presence of HTN, smoking, high age, dyslipidemia, female sex and insulin use. […] This study attempts to determine the prevalence and the risk factors of DR in adult diabetic patients in Upper Egypt during a 3-year period.

• #1 Prevalence and factors associated with Diabetes retinopathy among type 2 diabetic patients at Northwest Amhara Comprehensive Specialized Hospitals, Northwest Ethiopia 2021 | BMC Ophthalmology | Full Text

  https://bmcophthalmol.biomedcentral.com/articles/10.1186/s12886-022-02746-8

  Based on a pooled analysis of various hospital-based studies the prevalence of diabetic retinopathy is reported to be 31.6% in Africa and 19.48% in Ethiopia. […] The International Diabetic Federation estimated that the global prevalence of diabetic retinopathy in 2019 was more than 25%. […] The result of this study showed that 36.3% of study participants had diabetic retinopathy. […] The odds of diabetic retinopathy for male were 3.25 times that of females. […] The odds of diabetic retinopathy among diabetic patients who had no education was 4.23 times compared to diabetic patients who had a diploma and above. […] The odds of diabetic retinopathy among diabetic patients with glycemic control (HbA1c less than 7) had 9.9% less risky for diabetic retinopathy when compared to patients with glycemic control (HbA1c greater than 7). […] The odds of diabetic retinopathy among diabetic patients with hypertension had about 2.56 times chance of diabetic retinopathy than non-hypertensive patients. […] This study revealed that the prevalence of diabetic retinopathy was high (36.3%).

• #1 Prevalence and risk factors for diabetic retinopathy at diagnosis of type 2 diabetes: an observational study of 77 681 patients from the Swedish National Diabetes Registry | BMJ Open Diabetes Research & Care

  https://drc.bmj.com/content/12/3/e003976

  A higher proportion of patients with normal weight had DR at diagnosis of T2D compared with those who were overweight or obese. […] The prevalence of retinopathy as an indicator for late detected T2D has been used in several earlier studies. […] However, contemporary population-based studies of the prevalence of DR are overall sparse. […] It is possible that diabetes complications and mortality can be reduced during this high-risk phase if diabetes is detected early, and intensive prevention programs are started. […] In conclusion, intensified screening for T2D in clinical practice is needed in Sweden since almost one-fifth of these persons have retinopathy at diagnosis indicating long-standing hyperglycemia.

• #1 Prevalence of Diabetic Retinopathy – Prevent Blindness

  https://preventblindness.org/prevalence-of-diabetic-retinopathy-vehss/

  VTDR prevalence rates are higher for Black (8.7 percent) and Hispanic (7.1 percent) individuals than White individuals (3.6 percent). Thus, a higher percentage of Black and Hispanic individuals with diabetes are at risk for vision loss compared to their White counterparts. […] The prevalence of both DR and VTDR varied widely by U.S. state and county. After standardizing by age, sex/gender, and race/ethnicity, rates of DR among persons with diabetes ranged from a low of 21.2 percent in Nevada to a high of 34.2 percent in Hawaii. […] Prevalence of DR and VTDR among people with diabetes increased substantially with age but then decreased in the older age groups, likely because DR and VTDR are markers for more severe diabetes, which can lead to early mortality.

• #1 Diabetic Retinopathy: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/1225122-overview

  In a study using data from medical practices in East London, Nugawela et al found that among individuals with newly diagnosed type 2 diabetes, an increased risk of diabetic retinopathy existed in persons belonging to Indian, Pakistani, and African ethnic groups. Compared with the White population, the risk of sight-threatening diabetic retinopathy was highest in newly diagnosed people of African ethnicity, being 36% greater. […] With increasing duration of diabetes or with increasing age since its onset, there is a higher risk of developing diabetic retinopathy and its complications, including diabetic macular edema or proliferative diabetic retinopathy. […] Nonetheless, a literature review by Sabanayagam et al indicated that although the prevalence of diabetes has increased worldwide, the incidence of diabetic retinopathy-related blindness has fallen, especially in developed nations.

• #1 Epidemiology of diabetic retinopathy, diabetic macular edema and related vision loss

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4657234/

  In the UK, population studies involving patients with type 2 diabetes estimated cumulative incidence of DR to be 26.0 % at 4 years. […] The investigation of risk factors has also revealed interesting considerations both in clinical practice and research. Hyperglycemia remains the most important modifiable risk factor for DR, and intensive glycemic control has been proven to have potent and long-lasting protective effects against development and progression of DR and DME. […] Given the increasing affluence of developing economies such as China and India, the healthcare burden of DR can be expected to be on the uptrend in the decades ahead. […] In contrast to DR, the epidemiology of DME is much less well studied. Existing studies are split between the use of two diagnostic criteria, one for DME and the other for CSME. […] The association between DR and other vascular diseases are important areas of study. DR is strongly associated with nephropathy, which has significant burden on healthcare systems due to the need for renal replacement therapy.

• #1 Epidemiology of diabetic retinopathy, diabetic macular edema and related vision loss | Eye and Vision | Full Text

  https://eandv.biomedcentral.com/articles/10.1186/s40662-015-0026-2

  A large number of cohort studies have investigated progression and regression of DR. […] The prevalence of DME among recent cross-sectional studies is summarized in Table 4. Among the population-based studies, prevalence of DME among patients with type 1 diabetes was between 4.2 and 7.9 %. In patients with type 2 diabetes, it was between 1.4 and 12.8 %. […] Cohort studies that investigated DME incidence are summarized in Table 5. Only studies conducted in the US and Europe investigated DME incidence. […] The investigation of risk factors has also revealed interesting considerations both in clinical practice and research. Hyperglycemia remains the most important modifiable risk factor for DR, and intensive glycemic control has been proven to have potent and long-lasting protective effects against development and progression of DR and DME.

• #1 Epidemiology of diabetic retinopathy and macular oedema: a systematic review | Eye

  https://www.nature.com/articles/6701476

  The publications pertaining to prevalence and incidence of DR were found to be highly heterogeneous in terms of subject selection with variable inclusion criteria, such as age range, gender, diabetes duration and type, ethnicity, comorbidity and DR status, assessment and classification. […] Studies not confined to newly diagnosed diabetes show that the prevalence of DR in type I and type II diabetes is strongly correlated with duration of disease. […] The prevalence of MO has also been found to be related to the duration of the disease. […] The prevalence of clinically significant MO (ie MO that threatens central visual function; CSMO) is reportedly low in patients with type I diabetes (5%) and type II diabetes (2%) in the first years following diagnosis. However, this increases to more than 20% in people who have had type I diabetes for 25 years.

• #1 Advances in diabetic retinopathy surveillance | Ophthalmology Management

  https://www.ophthalmologymanagement.com/issues/2020/july/advances-in-diabetic-retinopathy-surveillance/

  The threat of diabetic retinopathy (DR) is a leading cause of vision loss in developed countries among adults aged 20 to 74 years. […] Nevertheless, screening and surveillance of the disease in its early stages remains a public-health challenge in many regions of the world. […] Studies from several developed countries have reported remarkable success in reducing rates of blindness due to DR through screening programs. […] Due to effective, population-based DR screening, multiple countries have documented a meaningful decrease in the prevalence of DR-associated visual loss. […] In the UK, a compelling decrease in the incidence of sight impairment due to DR has been documented. […] Also, in 2014, Liew et al reported that, for the first time in at least five decades, DR was no longer the leading cause of certifiable blindness among those aged 16 to 64 years old in England and Wales attributable to adherence with national DR screening guidelines.

• #1 Advances in diabetic retinopathy surveillance | Ophthalmology Management

  https://www.ophthalmologymanagement.com/issues/2020/july/advances-in-diabetic-retinopathy-surveillance/

  Similarly, in Poland a meaningful decrease in the incidence rate of blindness between 1989 and 2004 was attributed to the Saint Vincent Declaration of 1989, which set goals for improved diabetic health care, including the introduction of DR screening. […] But, in other developed countries, including the United States, adherence to screening recommendations among patients with DM is woefully suboptimal. […] Most organizations recommend annual DR-screening for patients with DM. […] A 2019 study reported that nearly one-third of type 1 and half of patients with type 2 DM did not have an eye exam during a 5-year study period, and only 26.3% and 15.3% met diabetic eye disease screening recommendations, respectively. […] Due to a failure of universal screening, DR remains the leading cause of blindness among working-age adults in the United States and is growing in prevalence. […] In this context, there remains a need for better, more consistent screening and surveillance of patients with DM to reduce rates of DR-related visual impairment.

• #1 JMIR Diabetes – Implementation of Teleophthalmology to Improve Diabetic Retinopathy Surveillance: Qualitative Interview Study of Clinical Staff Informed by Implementation Science Frameworks

  https://diabetes.jmir.org/2022/1/e32162/

  Diabetic retinopathy is the leading cause of blindness in working-age US adults, resulting in high personal, social, and economic costs. […] Teleophthalmology for diabetic retinopathy surveillance (DRS) is the store-and-forward process of remotely evaluating patients with diabetes for retinopathy. […] Although the effectiveness of teleophthalmology to substantially increase annual retinal screening rates for vision-threatening diabetic retinopathy at primary care clinics caring for low-income populations is well-established, sustained implementation is challenging. […] Implementation science is the systematic study of strategies to adopt and integrate evidence-based approaches into real-world practice. […] Frameworks and models from implementation science can be tailored to effectively study how and why teleophthalmology programs are accepted and sustained in some clinics but not in others.

• #1 JMIR Diabetes – Implementation of Teleophthalmology to Improve Diabetic Retinopathy Surveillance: Qualitative Interview Study of Clinical Staff Informed by Implementation Science Frameworks

  https://diabetes.jmir.org/2022/1/e32162/

  The project began as a community service quality improvement pilot project at 67% (2/3) of the clinics before the fee-for-service billing for the intervention was considered. […] Over 1 year of implementing the teleophthalmology program, each clinic doubled its annual retinal examination rate for patients with diabetes. […] Staff noted that having the program at their clinic brought a meaningful, novel way to help their patients. […] This belief was a strong motivator and provided buy-in at the individual level to adopt this program for patients with diabetes. […] Staff expressed concerns in making and tracking each referral to ophthalmology as they did not have the necessary resources to do so. […] The lack of awareness and recognition could potentially jeopardize the sustainability of the intervention and patients participation in follow-up visits. […] Overall, in our study, primary care staff expressed that having a teleophthalmology program for patients with diabetes in their clinics was valuable.

• #1

  https://www.feinberg.northwestern.edu/sites/ipham/news/Northwestern-to-study-main-cause-of-blindness-among-US-minority-populations.html

  Multiple factors influence a persons chances of developing DR, including central macular thickness, blood pressure, blood glucose levels, and cholesterol, which shall be studied jointly. […] Beyond the individual impact, diabetic retinopathy exacts a major economic toll in the United States. Its estimated that about $4 billion is spent annually on diabetic vision care.

• #1 Case Definitions: Diabetic Retinopathy (DR) | Vision and Eye Health Surveillance System | CDC

  https://www.cdc.gov/vision-health-data/case-definitions/diabetic-retinopathy.html

  VEHSS reports on the prevalence of diabetic retinopathy (DR) for the following categories based on these methods of identification: […] VEHSS summarizes the NHANES results, which represent a population-level prevalence estimate of DR defined as having a graded retinopathy level from 14 to 80 based on a modified Early Treatment Diabetic Retinopathy Study (ETDRS) scale in the worse affected eye. […] VEHSS summarizes the prevalence of self-reported diagnosed DR, which represents indicators of population prevalence of previously diagnosed DR. […] VEHSS reports the annual prevalence of diagnosed diabetic eye diseases based on the presence of International Classification of Diseases (ICD)-9 and ICD-10 codes in patient claims or electronic health record (EHR) systems. […] VEHSS defines the following summary subgroups indicating vision-threatening or nonvision-threatening DR. […] Vision-threatening DR includes severe nonproliferative, proliferative, or diabetic macular edema. […] Nonvision-threatening DR includes nonproliferative DR or other/unspecified diabetes-related eye conditions and not vision-threatening DR.

• #1 Study Finds Significantly More Adults Living with Diabetic Retinopathy in the United States than Previously Estimated – Prevent Blindness

  https://preventblindness.org/study-diabetic-retinopathy-estimates/

  A new study published today in JAMA Ophthalmology, Prevalence of Diabetic Retinopathy in the US in 2021, found that in 2021, an estimated 9.6 million people in the United States (26.4 percent of those with diabetes) had diabetic retinopathy (DR), and 1.84 million people (5.1 percent of those with diabetes) had vision-threatening diabetic retinopathy (VTDR). […] The national increase of diabetes over the last two decades has likely impacted the number of people living with serious complications like diabetic retinopathy, said CDC epidemiologist Elizabeth Lundeen, PhD, MPH. This study provides new state and county level prevalence estimates that the health care and public health communities can use to inform screening and early interventions for optimal vision health. […] This study demonstrates the value of vision surveillance, which allows us to monitor emerging trends in vision threatening conditions like diabetic retinopathy, said David B. Rein, Ph.D., Program Area Director for NORC at the University of Chicagos Public Health Analytics Program and one of the studys co-authors. The information provided in this study can be used at the national, state, and county level to understand the burden of diabetic retinopathy and to design interventions to help people living with the condition preserve their vision.

• #1 Diabetic retinopathy: Screening, prevention, and treatment | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/91/8/503

  Patients with type 1 and type 2 diabetes, including children, are at increased risk for diabetic retinopathy. These patients should be screened regularly with a comprehensive eye examination because symptoms may not occur until the disease has advanced and sight is threatened. […] Although there are effective treatments to prevent progression to sight-threatening diabetic retinopathy, management is not possible until diabetic retinopathy has been detected. […] Unfortunately, screening rates remain low, with less than 50% of patients with diabetes mellitus receiving appropriate ophthalmic care through referrals from primary care physicians. […] The American Diabetes Association recommends referring patients with type 1 diabetes to an ophthalmologist or optometrist for an initial dilated and comprehensive eye examination within 5 years of onset; patients with type 2 diabetes should be referred at the time of diagnosis.

• #1 Diabetic retinopathy: Screening, prevention, and treatment | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/91/8/503

  If any level of diabetic retinopathy is present on eye examination, the patient should receive dilated retinal examinations by an ophthalmologist or optometrist at least annually. […] Pregnancy increases the risk for the development and progression of diabetic retinopathy. […] Strict glycemic control has been established as absolutely key in preventing diabetic retinopathy progression, but evidence is mixed for targeting dyslipidemia and high blood pressure as measures specifically to prevent or slow the progression of diabetic retinopathy. […] The role of blood pressure management in the prevention of diabetic retinopathy has been explored. […] Diabetic retinopathy is associated with major systemic complications of diabetes. Its presence and severity have been shown to predict stroke, myocardial infarction, and death. […] Clinicians managing patients with diabetes mellitus must recognize the risks and complications associated with diabetic retinopathy and ensure that proper screening and referral processes are in place.

• #1 Review of the epidemiology of diabetic retinopathy

  https://www.modernretina.com/view/review-epidemiology-diabetic-retinopathy

  Systematic screening of diabetic patients has the potential to reduce the incidence of sight-threatening visual impairment. Such programmes have been successfully implemented in many countries. […] In the United Kingdom, the Clinical Practice Research Datalink (CPRD) electronic health database was used to examine trends in the prevalence and relative risk of retinopathy by diabetes type, patient age, sex, ethnicity, socioeconomic deprivation and region.6 Data were analysed from 7,707,475 patients aged over 12 years from 601 general practices across the UK that contributed to the CRPD from 2004 to 2014. […] Statistical analysis revealed that relative risk of DR in patients with type 2 diabetes mellitus varied significantly with region and was increased for older age groups and in men compared with women, with the risk of severe DR increased in South Asian ethnic groups and more deprived groups.

• #1 Diabetic Retinopathy Screening – EyeWiki

  https://eyewiki.org/Diabetic_Retinopathy_Screening

  The method used to screen for DR is dependent on resource settings. The 2018 ICO/ADA guidelines state that adequate DR screening should include a visual acuity exam and a retinal examination. […] Tele-retina has been proposed as a cost-effective alternative to examination by an ophthalmologist, whereby retinal images taken at one site are transmitted to and interpreted at another site. […] While there are benefits including reduced need for dilating medications and easy image acquisition with retinal photography, there are reports of high technical failure rates and the continued reliance on a trained image grader. […] The FDA in 2018 permitted marketing of the first authorized AI device to detect DR, Idx-DR.

• #1 Update in the epidemiology, risk factors, screening, and treatment of diabetic retinopathy – Oregon Health and Science University

  http://librarysearch.ohsu.edu/discovery/fulldisplay/cdi_doaj_primary_oai_doaj_org_article_5c97e7b68bfe499186a06673f18436b1/01ALLIANCE_OHSU:OHSU

  Update in the epidemiology, risk factors, screening, and treatment of diabetic retinopathy. […] Despite progress in the treatment of diabetic macular edema and diabetic retinopathy, the rate of lower fundus examination due to limitations of medical resources delays the diagnosis and treatment of diabetic retinopathy. Therefore, implementation of automated diabetic retinopathy screening program and the identification of more specific and sensitive biomarkers are important for facilitating the earlier detection of diabetic macular edema and diabetic retinopathy to decrease the prevalence of poor vision and blindness. […] Epidemiology.

• #1 Diabetic Retinopathy Screening – EyeWiki

  https://eyewiki.org/Diabetic_Retinopathy_Screening

  Diabetic retinopathy (DR) is the leading cause of preventable blindness. Of working-age Americans diagnosed with Diabetes Mellitus, it is estimated that about 1/3 have diabetic retinopathy (DR) and 4.4% have vision threatening retinopathy. […] Despite the high prevalence of DR, only 62.3 percent of patients with diabetes in the United States receive annual screening exams. […] Social determinates of health have an important role in DR screening rates. Numerous studies have identified lower educational status, lower income, minority race, recent immigration, residence in a rural community, and lack of health insurance with significantly decreased rates of DR screening. […] Increasing DR screening rates is an important goal of the US Department of Health and Human Services Healthy People 2030 campaign. The DR goals for Healthy People 2030 include increasing DR screening in people with diabetes from 62.3 percent to 67.7 percent and reducing vision loss from DR in people with diabetes from 33 percent to 16.5 percent.

• #1

  https://www.gov.uk/government/publications/diabetic-retinopathy-monitoring-and-treatment/closer-monitoring-and-treatment-of-diabetic-retinopathy

  This information is for people who have been referred from diabetic eye screening because they need: […] We need to monitor your eyes more closely in a surveillance clinic if you: […] Closer monitoring in a surveillance clinic can be offered every 3, 6, 9 or 12 months depending on the type and progression of the changes to your eyes. […] If your diabetic eye screening test shows signs of sight-threatening diabetic retinopathy we need to refer you to a hospital eye services clinic for further tests and possible treatment. […] An eye specialist, called an ophthalmologist, will examine your eyes. […] Laser treatment is the most common treatment for proliferative diabetic retinopathy and is most effective when the condition is detected early. […] Injections of vascular endothelial growth factor (VEG F) inhibitor drugs can reduce the risk of sight loss in some patients diagnosed with diabetic macular oedema.

• #1

  https://scholars.duke.edu/display/pub1150791

  Ten Emerging Trends in the Epidemiology of Diabetic Retinopathy. […] Diabetes is a major public health problem affecting 415 million people worldwide. With the increasing prevalence of diabetes, diabetic retinopathy (DR) is emerging as the leading cause of avoidable blindness worldwide. […] First, there is clear evidence of a global increase in the prevalence of diabetes. Second, there is a decline in the incidence of blindness due to DR, particularly in developed countries. […] Fourth, DR awareness remains patchy and low in most populations. […] Fifth, hyperglycemia remains the most consistent risk factor for DR in type 1 diabetes across different studies and populations. Sixth, in contrast, blood pressure is an important risk factor for DR in type 2 diabetes. […] Ninth, photographic screening of DR using tele-ophthalmology platforms is increasingly recognized as being feasible and cost-effective.

• #1 Epidemiology of diabetic retinopathy and macular oedema: a systematic review | Eye

  https://www.nature.com/articles/6701476

  As new therapies become available, the need to capture and monitor new epidemiological data becomes ever more important to help determine the size of the economic burden and also how progression of DR relates to novel treatments. […] Robust longitudinal collection of patient data will be essential to be able to identify the true extent of diagnosed retinal complications of diabetes, in turn providing healthcare planners with essential information to aid future decision-making.

• #1 Epidemiology of diabetic retinopathy and macular oedema: a systematic review | Eye

  https://www.nature.com/articles/6701476

  A total of 359 studies were included. The studies were reported in nearly 100 different journals and in over 50 countries. The majority of the studies were US-based, with large studies such as the Wisconsin Epidemiologic Study of Diabetic Retinopathy dominating the literature. […] There are inconsistencies between epidemiological studies, and differences in study methods may contribute to conflicting reports of prevalence and incidence of DR and MO in diabetic populations. As new therapies for DR and its associated complications emerge, the need to capture and monitor new epidemiological data becomes increasingly important to be able to assess the impact and effectiveness of these therapies. Robust, longitudinal capture of patient data is, therefore, essential to evaluate the impact of current practice on the epidemiology of diabetic eye complications.

• #1 Genetic epidemiology of diabetic retinopathy – Tom – Annals of Eye Science

  https://aes.amegroups.org/article/view/3795/html

  Linkage analyses identified possible loci with DR genes in the 1990s and 2000s. […] Population-based studies that seek to identify common genetic variants are more promising for polygenic diseases like DR. […] No consistent, rigorously replicated gene has emerged for DR, likely due to insufficient sample size, lack of comprehensive coverage of genetic variants, or incorrect hypotheses of the candidate genes involved. […] GWAS for DR are summarized in Table 1. […] Replication of associations with genome-wide significance has been challenging for DR. […] Current understanding of the genetics of DR is incomplete. […] GWAS will require larger international collaborative efforts to assemble multi-ethnic cohorts and increase sample sizes. […] Future studies also need to correctly account for glycemic control, which is strongly correlated with DR. […] Ongoing research in these areas and large collaborations for GWAS have the potential to illuminate the genetic foundations of DR.

• #1 Prevalence of diabetic retinopathy and vision-threatening diabetic retinopathy in adults with diabetes in China | Nature Communications

  https://www.nature.com/articles/s41467-023-39864-w

  This study showed that the top three province-specific prevalence of any DR and VTDR were all in the northern regions, and generally, a higher prevalence of any DR and VTDR was observed in the northern regions than in the southern regions. […] Regular screening for DR recommended by the American Diabetes Association and Chinese Diabetes Society and the establishment of a comprehensive eye screening system in China are necessary strategies to decrease vision loss caused by DR. […] Our study showed that multifaceted and tailored efforts to reduce the vision loss of patients with diabetes, including early and regular screening for DR, metabolic control improvement, educational improvement, lifestyle promotion, more care for these vulnerable and high-risk populations, and further exploration of geographical causes are necessary.

• #1 Genetic epidemiology of diabetic retinopathy – Tom – Annals of Eye Science

  https://aes.amegroups.org/article/view/3795/html

  The disease burden of diabetic retinopathy (DR) is tremendous around the world. […] There are an estimated 93 million people with diabetic retinopathy (DR) and 17 million with proliferative diabetic retinopathy (PDR) worldwide. […] Duration of type 1 diabetes (T1D) and type 2 diabetes (T2D) and hyperglycemia, as measured by hemoglobin A1c (HbA1c), are strongly associated risk factors for retinopathy. […] Genetic susceptibility may explain much of the heterogeneity in DR among patients with similar glycemic exposure. […] Linkage disequilibrium (LD) studies, candidate gene association studies, admixture analysis, and genome wide association studies have been conducted to try to elucidate the genetic factors that influence progression of DR. […] Heritabilities of PDR and DR are estimated at 2552% and 1827% respectively.

• #1 Epidemiology of diabetic retinopathy and maculopathy in Africa: a systematic review –

  https://research.sightsavers.org/gap-map/epidemiology-of-diabetic-retinopathy-and-maculopathy-in-africa-a-systematic-review/

  The review identified rates of prevalence of diabetic retinopathy in many areas of Africa comparable with high income countries. […] The prevalence of proliferative diabetic retinopathy and maculopathy was high in recent studies, particularly those from southern and eastern Africa. […] Authors concluded that large, community-based cross-sectional and cohort studies were needed to investigate rates and determinants of prevalence of diabetic retinopathy, incidence and progression in Africa. […] The main outcome measures included the prevalence of diabetic retinopathy, proliferative diabetic retinopathy and diabetic maculopathy and the incidence of diabetic retinopathy, proliferative diabetic retinopathy and diabetic maculopathy. […] It was noted in the review that few high-quality population-based studies were identified for inclusion in the review and the majority of studies included were hospital clinic based surveys of hospital attendees. […] Authors noted that with this type of study, selection bias was an issue and the findings should be generalized to other settings with caution.

• #1 Epidemiology of diabetic retinopathy and maculopathy in Africa: a systematic review –

  https://research.sightsavers.org/gap-map/epidemiology-of-diabetic-retinopathy-and-maculopathy-in-africa-a-systematic-review/

  The epidemic rise of diabetes in Africa poses significant public health and socio-economic challenges for the continent and potentially signals a rising prevalence of diseases such as diabetic retinopathy and diabetic maculopathy. […] To summarize findings from studies reporting the prevalence and incidence of diabetic retinopathy and diabetic maculopathy in African countries in light of the rising prevalence of diabetes mellitus. […] The review included 62 studies from 21 countries, all reporting the prevalence or incidence or progression of diabetic retinopathy or diabetic maculopathy in Africa. […] In population based studies the prevalence range in patients with diabetes for diabetic retinopathy was 30.2% to 31.6%, proliferative diabetic retinopathy 0.9% to 1.3% and any maculopathy 1.2% to 4.5%.

• #2 Prevalence of Diabetic Retinopathy – Prevent Blindness

  https://preventblindness.org/prevalence-of-diabetic-retinopathy-vehss/

  A new study published today in JAMA Ophthalmology, Prevalence of Diabetic Retinopathy in the US in 2021, found that in 2021, an estimated 9.6 million people in the United States (26.4 percent of those with diabetes) had diabetic retinopathy (DR), and 1.84 million people (5.1 percent of those with diabetes) had vision-threatening diabetic retinopathy (VTDR). […] The number of people aged 40 years and older living with diabetes-related eye disease more than doubled since prevalence was last estimated in 2004. […] VTDR has also almost doubled since last estimated in 2004. […] Approximately 1 in 4 Americans ages 40 and older with diabetes have DR. […] These new estimates include the prevalence of DR and VTDR in people younger than age 40 years. Past prevalence estimates were only for the US population aged 40 and older.

• #2 Diabetic Retinopathy: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/1225122-overview

  A study by Lundeen et al estimated, as stated above, that in 2021, 9.60 million people in the United States were living with diabetic retinopathy, or 26.43% of individuals living with diabetes. An estimated 1.84 million people (5.06% of people with diabetes), according to the report, were living with vision-threatening diabetic retinopathy, that is, severe nonproliferative retinopathy, proliferative retinopathy, panretinal photocoagulation scars, or macular edema. […] An increased risk of diabetic retinopathy appears to exist in patients of Native American, Hispanic, and African American heritage. […] A literature review by Teo et al indicated that the global prevalence of diabetic retinopathy among persons with diabetes is 22.27%, while the prevalence of sight-threatening diabetic retinopathy is 6.17%. Africa was found to have the highest prevalence of diabetic retinopathy, at 35.90% of individuals with diabetes, with the prevalence also being among the highest in North America and the Caribbean, at 33.30%. The investigators projected that the number of adults worldwide with diabetic retinopathy would rise from an estimated 103.12 million in 2020 to 160.50 million by 2045, with sight-threatening diabetic retinopathy rising from an estimated 28.54 million adults in 2020 to 44.82 million by 2045.

• #2 Epidemiology of diabetic retinopathy, diabetic macular edema and related vision loss | Eye and Vision | Full Text

  https://eandv.biomedcentral.com/articles/10.1186/s40662-015-0026-2

  In general, patients with type 2 diabetes in Western communities have a higher prevalence of DR than their Asian counterparts. […] In the USA, studies estimate that 28.540.3 % of patients with type 2 diabetes had DR, and 4.48.2 % of them had VTDR. […] In the Middle-East, Saudi Arabia and Iran both report prevalence that are similar to Western communities (36.8 and 29.6 %, respectively). […] Although duration of diabetes is a major risk factor for DR, a few studies reported DR prevalence in newly diagnosed diabetes. […] There are few population-based cohort studies, outside of the USA or UK, which have investigated DR incidence. […] In the UK, population studies involving patients with type 2 diabetes estimated cumulative incidence of DR to be 26.0 % at 4 years. […] As with prevalence, incidence data from Asia is restricted only to that of type 2 diabetes.

• #2 Prevalence of diabetic retinopathy and vision-threatening diabetic retinopathy in adults with diabetes in China | Nature Communications

  https://www.nature.com/articles/s41467-023-39864-w

  This study showed that the top three province-specific prevalence of any DR and VTDR were all in the northern regions, and generally, a higher prevalence of any DR and VTDR was observed in the northern regions than in the southern regions. […] Regular screening for DR recommended by the American Diabetes Association and Chinese Diabetes Society and the establishment of a comprehensive eye screening system in China are necessary strategies to decrease vision loss caused by DR. […] Our study showed that multifaceted and tailored efforts to reduce the vision loss of patients with diabetes, including early and regular screening for DR, metabolic control improvement, educational improvement, lifestyle promotion, more care for these vulnerable and high-risk populations, and further exploration of geographical causes are necessary.

• #2 Epidemiology of diabetic retinopathy, diabetic macular edema and related vision loss | Eye and Vision | Full Text

  https://eandv.biomedcentral.com/articles/10.1186/s40662-015-0026-2

  Diabetic retinopathy (DR) is a leading cause of vision-loss globally. Of an estimated 285 million people with diabetes mellitus worldwide, approximately one third have signs of DR and of these, a further one third of DR is vision-threatening DR, including diabetic macular edema (DME). […] The most clinically important risk factors for progression to vision loss include duration of diabetes, hyperglycemia and hypertension. Control of serum glucose and blood pressure have been shown to be effective in preventing vision loss due to DR. […] Prevalence and risk factors of DR have been studied widely in previous studies including regional and ethnic differences, but epidemiological data on DME are relatively scarce. […] A pooled individual participant meta-analysis involving 35 studies conducted worldwide from 1980 to 2008, estimated global prevalence of any DR and PDR among patients with diabetes to be 35.4 and 7.5 % respectively.

• #2 Prevalence and factors associated with Diabetes retinopathy among type 2 diabetic patients at Northwest Amhara Comprehensive Specialized Hospitals, Northwest Ethiopia 2021 | BMC Ophthalmology | Full Text

  https://bmcophthalmol.biomedcentral.com/articles/10.1186/s12886-022-02746-8

  Based on a pooled analysis of various hospital-based studies the prevalence of diabetic retinopathy is reported to be 31.6% in Africa and 19.48% in Ethiopia. […] The International Diabetic Federation estimated that the global prevalence of diabetic retinopathy in 2019 was more than 25%. […] The result of this study showed that 36.3% of study participants had diabetic retinopathy. […] The odds of diabetic retinopathy for male were 3.25 times that of females. […] The odds of diabetic retinopathy among diabetic patients who had no education was 4.23 times compared to diabetic patients who had a diploma and above. […] The odds of diabetic retinopathy among diabetic patients with glycemic control (HbA1c less than 7) had 9.9% less risky for diabetic retinopathy when compared to patients with glycemic control (HbA1c greater than 7). […] The odds of diabetic retinopathy among diabetic patients with hypertension had about 2.56 times chance of diabetic retinopathy than non-hypertensive patients. […] This study revealed that the prevalence of diabetic retinopathy was high (36.3%).

• #2 Epidemiology of diabetic retinopathy, diabetic macular edema and related vision loss | Eye and Vision | Full Text

  https://eandv.biomedcentral.com/articles/10.1186/s40662-015-0026-2

  Given the increasing affluence of developing economies such as China and India, the healthcare burden of DR can be expected to be on the uptrend in the decades ahead. […] In contrast to DR, the epidemiology of DME is much less well studied. Existing studies are split between the use of two diagnostic criteria, one for DME and the other for CSME. […] The association between DR and other vascular diseases are important areas of study. DR is strongly associated with nephropathy, which has significant burden on healthcare systems due to the need for renal replacement therapy.

• #2 Epidemiology of diabetic retinopathy, diabetic macular edema and related vision loss | springermedizin.de

  https://www.springermedizin.de/epidemiology-of-diabetic-retinopathy-diabetic-macular-edema-and-/50291410

  The prevalence of DME among recent cross-sectional studies is summarized in Table 4. Among the population-based studies, prevalence of DME among patients with type 1 diabetes was between 4.2 and 7.9 %. In patients with type 2 diabetes, it was between 1.4 and 12.8 %. […] The prevalence of DME among patients with diabetes is generally much lower than that of DR. […] In the Diabetic Retinopathy Screening Service for Wales, a high prevalence of DR (56.0 % in type 1 diabetes, 30.3 % in type 2 diabetes) was reported, but the prevalence of DME was not found to be higher than other studies (4.2 % in type 1 diabetes, 1.4 % in type 2 diabetes). […] A recent systematic review estimated that in 2010, 3.63 million people worldwide suffer from moderate and severe vision loss due to DR and its related sequelae. An estimated 850 thousand more people suffer from DR-related blindness. […] The presence of DR was also associated with mortality from cardiovascular disease, especially if there is concomitant nephropathy.

• #2 Advances in diabetic retinopathy surveillance | Ophthalmology Management

  https://www.ophthalmologymanagement.com/issues/2020/july/advances-in-diabetic-retinopathy-surveillance/

  The threat of diabetic retinopathy (DR) is a leading cause of vision loss in developed countries among adults aged 20 to 74 years. […] Nevertheless, screening and surveillance of the disease in its early stages remains a public-health challenge in many regions of the world. […] Studies from several developed countries have reported remarkable success in reducing rates of blindness due to DR through screening programs. […] Due to effective, population-based DR screening, multiple countries have documented a meaningful decrease in the prevalence of DR-associated visual loss. […] In the UK, a compelling decrease in the incidence of sight impairment due to DR has been documented. […] Also, in 2014, Liew et al reported that, for the first time in at least five decades, DR was no longer the leading cause of certifiable blindness among those aged 16 to 64 years old in England and Wales attributable to adherence with national DR screening guidelines.

• #2 Advances in diabetic retinopathy surveillance | Ophthalmology Management

  https://www.ophthalmologymanagement.com/issues/2020/july/advances-in-diabetic-retinopathy-surveillance/

  Similarly, in Poland a meaningful decrease in the incidence rate of blindness between 1989 and 2004 was attributed to the Saint Vincent Declaration of 1989, which set goals for improved diabetic health care, including the introduction of DR screening. […] But, in other developed countries, including the United States, adherence to screening recommendations among patients with DM is woefully suboptimal. […] Most organizations recommend annual DR-screening for patients with DM. […] A 2019 study reported that nearly one-third of type 1 and half of patients with type 2 DM did not have an eye exam during a 5-year study period, and only 26.3% and 15.3% met diabetic eye disease screening recommendations, respectively. […] Due to a failure of universal screening, DR remains the leading cause of blindness among working-age adults in the United States and is growing in prevalence. […] In this context, there remains a need for better, more consistent screening and surveillance of patients with DM to reduce rates of DR-related visual impairment.

• #2 JMIR Diabetes – Implementation of Teleophthalmology to Improve Diabetic Retinopathy Surveillance: Qualitative Interview Study of Clinical Staff Informed by Implementation Science Frameworks

  https://diabetes.jmir.org/2022/1/e32162/

  Diabetic retinopathy is the leading cause of blindness in working-age US adults, resulting in high personal, social, and economic costs. […] Teleophthalmology for diabetic retinopathy surveillance (DRS) is the store-and-forward process of remotely evaluating patients with diabetes for retinopathy. […] Although the effectiveness of teleophthalmology to substantially increase annual retinal screening rates for vision-threatening diabetic retinopathy at primary care clinics caring for low-income populations is well-established, sustained implementation is challenging. […] Implementation science is the systematic study of strategies to adopt and integrate evidence-based approaches into real-world practice. […] Frameworks and models from implementation science can be tailored to effectively study how and why teleophthalmology programs are accepted and sustained in some clinics but not in others.

• #2 Case Definitions: Diabetic Retinopathy (DR) | Vision and Eye Health Surveillance System | CDC

  https://www.cdc.gov/vision-health-data/case-definitions/diabetic-retinopathy.html

  VEHSS reports on the prevalence of diabetic retinopathy (DR) for the following categories based on these methods of identification: […] VEHSS summarizes the NHANES results, which represent a population-level prevalence estimate of DR defined as having a graded retinopathy level from 14 to 80 based on a modified Early Treatment Diabetic Retinopathy Study (ETDRS) scale in the worse affected eye. […] VEHSS summarizes the prevalence of self-reported diagnosed DR, which represents indicators of population prevalence of previously diagnosed DR. […] VEHSS reports the annual prevalence of diagnosed diabetic eye diseases based on the presence of International Classification of Diseases (ICD)-9 and ICD-10 codes in patient claims or electronic health record (EHR) systems. […] VEHSS defines the following summary subgroups indicating vision-threatening or nonvision-threatening DR. […] Vision-threatening DR includes severe nonproliferative, proliferative, or diabetic macular edema. […] Nonvision-threatening DR includes nonproliferative DR or other/unspecified diabetes-related eye conditions and not vision-threatening DR.

• #2 Diabetic Retinopathy Screening – EyeWiki

  https://eyewiki.org/Diabetic_Retinopathy_Screening

  The method used to screen for DR is dependent on resource settings. The 2018 ICO/ADA guidelines state that adequate DR screening should include a visual acuity exam and a retinal examination. […] Tele-retina has been proposed as a cost-effective alternative to examination by an ophthalmologist, whereby retinal images taken at one site are transmitted to and interpreted at another site. […] While there are benefits including reduced need for dilating medications and easy image acquisition with retinal photography, there are reports of high technical failure rates and the continued reliance on a trained image grader. […] The FDA in 2018 permitted marketing of the first authorized AI device to detect DR, Idx-DR.

• #2 Diabetic Retinopathy Screening – EyeWiki

  https://eyewiki.org/Diabetic_Retinopathy_Screening

  Diabetic retinopathy (DR) is the leading cause of preventable blindness. Of working-age Americans diagnosed with Diabetes Mellitus, it is estimated that about 1/3 have diabetic retinopathy (DR) and 4.4% have vision threatening retinopathy. […] Despite the high prevalence of DR, only 62.3 percent of patients with diabetes in the United States receive annual screening exams. […] Social determinates of health have an important role in DR screening rates. Numerous studies have identified lower educational status, lower income, minority race, recent immigration, residence in a rural community, and lack of health insurance with significantly decreased rates of DR screening. […] Increasing DR screening rates is an important goal of the US Department of Health and Human Services Healthy People 2030 campaign. The DR goals for Healthy People 2030 include increasing DR screening in people with diabetes from 62.3 percent to 67.7 percent and reducing vision loss from DR in people with diabetes from 33 percent to 16.5 percent.

• #2

  https://www.gov.uk/government/publications/diabetic-retinopathy-monitoring-and-treatment/closer-monitoring-and-treatment-of-diabetic-retinopathy

  This information is for people who have been referred from diabetic eye screening because they need: […] We need to monitor your eyes more closely in a surveillance clinic if you: […] Closer monitoring in a surveillance clinic can be offered every 3, 6, 9 or 12 months depending on the type and progression of the changes to your eyes. […] If your diabetic eye screening test shows signs of sight-threatening diabetic retinopathy we need to refer you to a hospital eye services clinic for further tests and possible treatment. […] An eye specialist, called an ophthalmologist, will examine your eyes. […] Laser treatment is the most common treatment for proliferative diabetic retinopathy and is most effective when the condition is detected early. […] Injections of vascular endothelial growth factor (VEG F) inhibitor drugs can reduce the risk of sight loss in some patients diagnosed with diabetic macular oedema.

• #2

  https://scholars.duke.edu/display/pub1150791

  Finally, DR prevention in low-resource settings cannot follow models developed in high-resource countries and requires different strategies. […] The ten trends we observed in the current review may guide planning of public healthcare strategies for the management of DR and prevention of blindness.

• #2 Genetic epidemiology of diabetic retinopathy – Tom – Annals of Eye Science

  https://aes.amegroups.org/article/view/3795/html

  The disease burden of diabetic retinopathy (DR) is tremendous around the world. […] There are an estimated 93 million people with diabetic retinopathy (DR) and 17 million with proliferative diabetic retinopathy (PDR) worldwide. […] Duration of type 1 diabetes (T1D) and type 2 diabetes (T2D) and hyperglycemia, as measured by hemoglobin A1c (HbA1c), are strongly associated risk factors for retinopathy. […] Genetic susceptibility may explain much of the heterogeneity in DR among patients with similar glycemic exposure. […] Linkage disequilibrium (LD) studies, candidate gene association studies, admixture analysis, and genome wide association studies have been conducted to try to elucidate the genetic factors that influence progression of DR. […] Heritabilities of PDR and DR are estimated at 2552% and 1827% respectively.

• #2 Genetic epidemiology of diabetic retinopathy – Tom – Annals of Eye Science

  https://aes.amegroups.org/article/view/3795/html

  Linkage analyses identified possible loci with DR genes in the 1990s and 2000s. […] Population-based studies that seek to identify common genetic variants are more promising for polygenic diseases like DR. […] No consistent, rigorously replicated gene has emerged for DR, likely due to insufficient sample size, lack of comprehensive coverage of genetic variants, or incorrect hypotheses of the candidate genes involved. […] GWAS for DR are summarized in Table 1. […] Replication of associations with genome-wide significance has been challenging for DR. […] Current understanding of the genetics of DR is incomplete. […] GWAS will require larger international collaborative efforts to assemble multi-ethnic cohorts and increase sample sizes. […] Future studies also need to correctly account for glycemic control, which is strongly correlated with DR. […] Ongoing research in these areas and large collaborations for GWAS have the potential to illuminate the genetic foundations of DR.

• #3 Prevalence of diabetic retinopathy in the US in 2021 | Institute for Health Metrics and Evaluation

  https://www.healthdata.org/research-analysis/library/prevalence-diabetic-retinopathy-us-2021

  In 2021, an estimated 9.6 million people were living with diabetic retinopathy, and an estimated 1.8 million people were living with vision-threatening diabetic retinopathy. […] Diabetic retinopathy (DR) is a common microvascular complication of diabetes and a leading cause of blindness among working-age adults in the US. […] For 2021, the study team estimated 9.60 million people (95% uncertainty interval [UI], 7.90-11.55) living with DR, corresponding to a prevalence rate of 26.43% (95% UI, 21.95-31.60) among people with diabetes. The study team estimated 1.84 million people (95% UI, 1.41-2.40) living with VTDR, corresponding to a prevalence rate of 5.06% (95% UI, 3.90-6.57) among people with diabetes. Prevalence of DR and VTDR varied by demographic characteristics and geography. […] US prevalence of diabetes-related eye disease remains high. These updated estimates on the burden and geographic distribution of diabetes-related eye disease can be used to inform the allocation of public health resources and interventions to communities and populations at highest risk.

• #3 Diabetic Retinopathy: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/1225122-overview

  A study by Lundeen et al estimated, as stated above, that in 2021, 9.60 million people in the United States were living with diabetic retinopathy, or 26.43% of individuals living with diabetes. An estimated 1.84 million people (5.06% of people with diabetes), according to the report, were living with vision-threatening diabetic retinopathy, that is, severe nonproliferative retinopathy, proliferative retinopathy, panretinal photocoagulation scars, or macular edema. […] An increased risk of diabetic retinopathy appears to exist in patients of Native American, Hispanic, and African American heritage. […] A literature review by Teo et al indicated that the global prevalence of diabetic retinopathy among persons with diabetes is 22.27%, while the prevalence of sight-threatening diabetic retinopathy is 6.17%. Africa was found to have the highest prevalence of diabetic retinopathy, at 35.90% of individuals with diabetes, with the prevalence also being among the highest in North America and the Caribbean, at 33.30%. The investigators projected that the number of adults worldwide with diabetic retinopathy would rise from an estimated 103.12 million in 2020 to 160.50 million by 2045, with sight-threatening diabetic retinopathy rising from an estimated 28.54 million adults in 2020 to 44.82 million by 2045.

• #3 Case Definitions: Diabetic Retinopathy (DR) | Vision and Eye Health Surveillance System | CDC

  https://www.cdc.gov/vision-health-data/case-definitions/diabetic-retinopathy.html

  VEHSS reports on the prevalence of diabetic retinopathy (DR) for the following categories based on these methods of identification: […] VEHSS summarizes the NHANES results, which represent a population-level prevalence estimate of DR defined as having a graded retinopathy level from 14 to 80 based on a modified Early Treatment Diabetic Retinopathy Study (ETDRS) scale in the worse affected eye. […] VEHSS summarizes the prevalence of self-reported diagnosed DR, which represents indicators of population prevalence of previously diagnosed DR. […] VEHSS reports the annual prevalence of diagnosed diabetic eye diseases based on the presence of International Classification of Diseases (ICD)-9 and ICD-10 codes in patient claims or electronic health record (EHR) systems. […] VEHSS defines the following summary subgroups indicating vision-threatening or nonvision-threatening DR. […] Vision-threatening DR includes severe nonproliferative, proliferative, or diabetic macular edema. […] Nonvision-threatening DR includes nonproliferative DR or other/unspecified diabetes-related eye conditions and not vision-threatening DR.

• #3 Diabetic Retinopathy Screening – EyeWiki

  https://eyewiki.org/Diabetic_Retinopathy_Screening

  The method used to screen for DR is dependent on resource settings. The 2018 ICO/ADA guidelines state that adequate DR screening should include a visual acuity exam and a retinal examination. […] Tele-retina has been proposed as a cost-effective alternative to examination by an ophthalmologist, whereby retinal images taken at one site are transmitted to and interpreted at another site. […] While there are benefits including reduced need for dilating medications and easy image acquisition with retinal photography, there are reports of high technical failure rates and the continued reliance on a trained image grader. […] The FDA in 2018 permitted marketing of the first authorized AI device to detect DR, Idx-DR.

• #3

  https://www.gov.uk/government/publications/diabetic-retinopathy-monitoring-and-treatment/closer-monitoring-and-treatment-of-diabetic-retinopathy

  This information is for people who have been referred from diabetic eye screening because they need: […] We need to monitor your eyes more closely in a surveillance clinic if you: […] Closer monitoring in a surveillance clinic can be offered every 3, 6, 9 or 12 months depending on the type and progression of the changes to your eyes. […] If your diabetic eye screening test shows signs of sight-threatening diabetic retinopathy we need to refer you to a hospital eye services clinic for further tests and possible treatment. […] An eye specialist, called an ophthalmologist, will examine your eyes. […] Laser treatment is the most common treatment for proliferative diabetic retinopathy and is most effective when the condition is detected early. […] Injections of vascular endothelial growth factor (VEG F) inhibitor drugs can reduce the risk of sight loss in some patients diagnosed with diabetic macular oedema.

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