Abstract
Abstract: :
Purpose: To determine the United States (US) prevalences of diabetic retinopathy (DR) in adults with diabetes mellitus (DM) and in the adult general population. Methods: Counts of the numbers of adults with DM and with DR in strata of gender, race, and age were obtained from participating population-based studies that used fundus photography to assess diabetic retinopathy: the Barbados Eye Study, the Blue Mountains Eye Study, the Beaver Dam Eye Study, Proyecto VER, the San Antonio Heart Study, the Visual Impairment Project, and the Wisconsin Epidemiologic Study of Diabetic Retinopathy. Data from the San Luis Valley Diabetes Study, designed to ascertain all cases of DM in a defined geographical area, were also included. DR severity based on fundus photograph gradings using the Early Treatment of Diabetic Retinopathy Study interim or final scale was categorized based on each participant's worse eye as none (<14); «mild» (14-<40); "moderate" (40-<50); or "severe" (50+). Macular edema (ME) was defined as present or absent, by person. Advanced, vision-threatening DR ("VTDR") was defined as severe retinopathy, ME, or both in either eye. Stratum-specific prevalences for retinopathy categories among diabetics were calculated. The 1999 National Health Interview Survey (NHIS) was used to estimate the prevalence of self-reported DM and the size of the total population in each gender-race-age stratum. These values were combined with the stratum-specific prevalences of retinopathy among persons with DM and summed to generate estimates of the US prevalences of DR among adults with DM and in the adult general population. Results: Among the estimated 199.6 million US adults aged 18 years or more in 1999, an estimated 10.8 million (5.4%) had (self-reported) DM. The estimated 1999 prevalence of DR is summarized in the table below. Conclusion: Diabetic retinopathy is an important public health problem in the US. Over five million adults are affected. One of every 128 adults has advanced, vision-threatening disease. US Prevalence of Diabetic Retinopathy, 1999 (Worse Eye)
Keywords: 388 diabetic retinopathy • 354 clinical (human) or epidemiologic studies: prevalence/incidence • 387 diabetes