Global Prevalence and Major Risk Factors of Diabetic Retinopathy

Diabetes Care - Tập 35 Số 3 - Trang 556-564 - 2012
Joanne Yau1, Sophie Rogers1, Ryo Kawasaki1, Ecosse L. Lamoureux1,2, Jonathan W. Kowalski3, Toke Bek4, Shih‐Jen Chen5, Joost Dekker6, Astrid Fletcher7, Jakob Grauslund8, Steven E. Kahn9, Richard F. Hamman10, M. Kamran Ikram11, Takamasa Kayama12, Barbara E.K. Klein13, Ronald Klein13, Sannapaneni Krishnaiah14, Korapat Mayurasakorn15, Joseph Paul O’Hare16, Trevor J. Orchard17, Massimo Porta18, M. Rema19, Monique Roy20, Tarun Sharma21, Jonathan E. Shaw22, Hugh R. Taylor23, James M. Tielsch24, Rohit Varma25, Jie Jin Wang26, Ningli Wang27, Sheila K. West28, Ian S. Young29, Miho Yasuda30, Xinzhi Zhang31, Paul Mitchell26, Tien Yin Wong1,32,2
1Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
2Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
3Global Health Outcomes Strategy and Research, Allergan, Inc., Irvine, California.
4Department of Ophthalmology, Aarhus University Hospital, Aarhus, Denmark
5Department of Ophthalmology, Taipei Veterans General Hospital, National Yang-Ming University, Taipei, Taiwan
6Department of Epidemiology and Biostatistics and the EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
7Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, U.K.
8Department of Ophthalmology, Odense University Hospital, Odense, Denmark
9Shavano Park, Texas
10Department of Epidemiology, Colorado School of Public Health, Aurora, Colorado.
11Departments of Epidemiology and Ophthalmology, Erasmus Medical Center, Rotterdam, the Netherlands
12National Cancer Center/Department of Neurosurgery, Advanced Molecular Epidemiology Research Institute, Faculty of Medicine, Yamagata University, Yamagata, Japan
13Department of Ophthalmology and Visual Sciences, University of Wisconsin, Madison, Wisconsin
14Center for Clinical Epidemiology and Biostatistics, L V Prasad Eye Institute, Hyderabad, India
15Department of Social Medicine, Samutsakhon General Hospital, Samutsakhon, Thailand
16Clinical Sciences Research Institute, Warwick Medical School, University of Warwick, Coventry, U.K.
17Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
18Department of Internal Medicine, University of Turin, Turin, Italy
19Department of Ophthalmology, Madras Diabetes Research Foundation, Chennai, India
20Institute of Ophthalmology and Visual Science, University of New Jersey, Newark, New Jersey
21Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, Chennai, Tamil Nadu, India
22Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia
23Melbourne School of Population Health, University of Melbourne, Melbourne, Victoria, Australia
24Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
25Doheny Eye Institute, Keck School of Medicine, University of Southern California, Los Angeles, California
26Centre for Vision Research, Westmead Millennium Institute, University of Sydney, Sydney, New South Wales, Australia
27Beijing Tongren Hospital, Capital Medical University, Beijing, China
28Wilmer Eye Institute, Johns Hopkins Hospital, Baltimore, Maryland
29Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
30Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
31Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention Atlanta, Georgia
32Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore

Tóm tắt

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.

Từ khóa


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Diabetes Care

Tập 35 Số 3

556-564

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