Prevalence of diabetic retinopathy among 13473 patients with diabetes mellitus in China: a cross-sectional epidemiological survey in six provinces

Abstract

ObjectiveTo describe the prevalence and severity of diabetic retinopathy (DR) and sight-threatening DR (STDR) among Chinese adults with diabetes.Design, setting and participantsA cross-sectional epidemiological survey across Mainland China (N=13 473). Participants were diagnosed with diabetes mellitus by physicians and transferred to our screening clinics (1/3 from hospital patients, 1/3 from city residents, the other 1/3 from rural residents). 2 fundus photographs were taken of each eye with a colourful, non-mydriatic and non-stereoscopic camera and were graded according to the UK guidelines.Main outcomes and measuresThe prevalence and severity of DR and STDR.ResultsOf the 13 473 participants with diabetes participating in the study, 4591 had DR and 1769 had STDR, for an overall prevalence of 34.08% (95% CI 33.28% to 34.88%) and 13.13% (95% CI 12.56% to 13.70%), respectively. Among these, gradable photographs were available for 12 780 participants (94.86%). Participants who were aged >65 years were less likely to suffer from DR or STDR (p<0.001; age distribution). No gender-related differences were present (p>0.05). Participants with STDR suffered from more severe visual impairment compared with those without STDR (p<0.001). The prevalence of DR and STDR in the northern region was higher than in the southern region (p<0.001). The prevalence of DR was closely related to duration of disease (OR 2.63; 95% CI 2.42 to 2.86; p<0.001) and diabetes onset age (OR 0.38; 95% CI 0.35 to 0.41; p<0.001).ConclusionsThe prevalence of DR and STDR in Mainland China appeared a little high, and varied according to area. Non-proliferative DR was more common, but STDR needed prompt treatment, especially in economically less developed areas. This study highlights the necessity for DR screening and treatment in Mainland China.

The profile of sight-threatening diabetic retinopathy in patients attending a specialist eye clinic in Hangzhou, China

“…They did not report prevalence rates for STDR and therefore a direct comparison is difficult. Liu et al 27 conducted a cross-sectional study in six provinces of mainland China, in which patients were mixed: one-third of the patients were city residents, one-third were rural residents and one-third were hospital patients. They found the prevalence of any form of DR to be 34%, and STDR to be 13%.…”

Association of diabetic retinopathy and diabetic macular oedema with renal function in southern Chinese patients with type 2 diabetes mellitus: a single-centre observational study

“…However, DR is always asymptomatic until it comes to advanced stages or occurrence of diabetic macular oedema (DME) leading to vision loss. Timely and reduplicative screening of DR can slow down its development, but the huge number of patients with diabetes and lack of ophthalmologists hampers frequent screening, especially in China 3. Therefore, how to screen DR more efficiently becomes an important issue in today’s medical environment.…”

Risk factors of diabetic retinopathy and sight-threatening diabetic retinopathy: a cross-sectional study of 13 473 patients with type 2 diabetes mellitus in mainland China

“…The prevalence of DR and its basic epidemiological characteristics have been reported in a previously published article. 31 In this study, we sought to explore the risk factors associated with DR and STDR in mainland China.…”