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Tien Y. Wong, Joanne Yau, Sophie Rogers, Ryo Kawasaki, Ecosse L. Lamoureux, Meta-Eye Group, Jonathan Kowalski; Global Prevalence of Diabetic Retinopathy: Pooled Data from Population Studies from the United States, Australia, Europe and Asia. Invest. Ophthalmol. Vis. Sci. 2011;52(14):4818.
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To estimate the global prevalence of any diabetic retinopathy (DR), proliferative diabetic retinopathy (PDR), diabetic macular edema (DME) and vision-threatening diabetic retinopathy (VTDR) (defined as PDR and/or DME) based on pooled data from studies in the United States, Australia, Europe and Asia.
Population-based studies of general or diabetic populations where DR status was ascertained from fundus photography were invited for collaboration. Studies provided individual participant data regarding any DR, PDR, DME, age, gender, ethnicity and other risk factors. Pooled prevalence was directly age-sex-standardized to the 2010 world diabetes population (age 20-79 years)
A total of 35 studies provided data from 22,896 diabetic subjects aged from 3 to 97 years. Median duration of diabetes was 7.8 years and mean HbA1C was 8.5%. Based on our analysis of high quality studies only, the age-standardized prevalence was 35.36% (95% confidence interval [CI] 35.17-35.56%) for any DR, 7.24% (CI: 7.15-7.33%) for PDR, 7.48% (CI: 7.39-7.57%) for DME and 11.72% (CI: 11.61-11.83%) for VTDR. Prevalence of VTDR was markedly higher in people with type 1 diabetes than type 2 (38.5% vs. 6.92%), and increased with diabetes duration (3.78% in persons with diabetes for <10 years to 31.0% in those with 20+ years’ duration), increasing levels of HbA1C (5.4% for HbA1c ≤7.0% vs. 18.35% for HbA1C >9.0%), and blood pressure (7.6% vs. 17.63% in non-hypertensive vs. hypertensive individuals respectively).
Our study estimates that in 2010 (2030), globally, there are approximately 100.8 (154.9) million people with DR, 20.6 (31.7) million with PDR, 21.3 (32.8) million with DME and 33.4 (51.3) million with VTDR. Diabetes duration, poorer glycemic and blood pressure control are strongly associated with a higher prevalence of these endpoints. These data highlight the substantial public health impact of diabetes.
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