Diabetic retinopathy: global prevalence, major risk factors, screening practices and public health challenges: a review

Abstract

Diabetes retinopathy (DR) is a leading cause of vision loss in middle-aged and elderly people globally. Early detection and prompt treatment allow prevention of diabetes-related visual impairment. Patients with diabetes require regular follow-up with primary care physicians to optimize their glycaemic, blood pressure and lipid control to prevent development and progression of DR and other diabetes-related complications. Other risk factors of DR include higher body mass index, puberty and pregnancy, and cataract surgery. There are weaker associations with some genetic and inflammatory markers. With the rising incidence and prevalence of diabetes and DR, public health systems in both developing and developed countries will be faced with increasing costs of implementation and maintenance of a DR screening program for people with diabetes. To reduce the impact of DR-related visual loss, it is important that all stakeholders continue to look for innovative ways of managing and preventing diabetes, and optimize cost-effective screening programs within the community.

The Impact of Expanding the Screening Interval for Diabetic Retinopathy in Primary Care Centers

“…Similar findings have been reported in studies from China, Finland, Jordan and Saudi Arabia [9,23,24,28,36]. Hypertension has a strong association with DR (P-value 0.0001), and this was well documented in most of the other studies [24,32,33,37,38]. Like other studies, smoking was not associated with DR (P-value 0.992) [5,9,11,24,39].…”

“…Regarding association of obesity with diabetic retinopathy, this study found no significant association, since the relative risk (RR) of BMI (less than 30/more than 30) was 0.615 (95% CI 0.334-1.130). Although a positive correlation of obesity with DR has been found in some studies [3,9,24,[32][33][34], it was found to be protective in another studies [9)]. Controlling blood sugar is a protective factor [5,8,11,32,33,35], and this association was proven in this study.…”

“…Although a positive correlation of obesity with DR has been found in some studies [3,9,24,[32][33][34], it was found to be protective in another studies [9)]. Controlling blood sugar is a protective factor [5,8,11,32,33,35], and this association was proven in this study. Glycemic level was controlled in only 2.6% of the DR cases, while 97.4% of the DR cases were uncontrolled and had HBA1C level >8.1 (P-value 0.005); the relative risk was 0.25 (95% CI 0.113-0.586).…”

“…There was no significant association with gender, in contrast to some studies which reported a predominance for males [28,30]. There was no significant association with the type of diabetes mellitus, although studies around the world found that the prevalence of diabetic retinopathy was higher in people with type 1 diabetes than in those with type 2 diabetes [8,31,32]. Regarding association of obesity with diabetic retinopathy, this study found no significant association, since the relative risk (RR) of BMI (less than 30/more than 30) was 0.615 (95% CI 0.334-1.130).…”

A CCR2/5 Inhibitor, PF-04634817, Is Inferior to Monthly Ranibizumab in the Treatment of Diabetic Macular Edema

“…1,2 Diabetic retinopathy, a microvascular complication of diabetes 3 associated with various risk factors including poor glycemic control, 3 is a leading cause of acquired vision loss in adults, 4,5 and in 2010 was attributed to 2.6% of global blindness. 6 Anatomical and biochemical changes resulting from retinopathy may lead to diabetic macular edema (DME) in up to a third of patients with diabetes 7,8 and is characterized clinically by swelling of the macula due to increased permeability of blood vessels.…”