Prevalence of diabetic retinopathy in urban and rural India: A systematic review and meta-analysis

Abstract

A systematic review and meta-analysis were conducted to estimate the prevalence of diabetic retinopathy (DR) in India’s urban and rural areas. Medline, Scopus, and ScienceDirect databases were searched for population-based studies published in English between January 1990 and April 2021, wherein the prevalence of DR among Indian residents with type 2 diabetes mellitus (DM) was reported. A random-effects model was used to estimate the overall, rural, and urban prevalence. Data from 10 eligible studies were aggregated for meta-analysis. The prevalence of DR was 17.44% (95% confidence interval [CI], 14.33–20.55) in urban and 14.00% (95% CI: 9.13–18.86) in rural population ( P = 0.24). The overall DR prevalence was 16.10% (95% CI: 13.16–24.32), and the population prevalence was 1.63% [95% CI: 0.94–2.32]. Prevalence of DR in people with diabetes was lower in the age group of 40–49 years [13.57% (95% CI: 7.16–19.98)] than in the age group of 50–59 years [16.72% (95% CI: 12.80–20.64)] and the age group of 60 years and above [16.55% (95% CI: 12.09–21.00)]. Variability in studies was high: urban ( I 2 = 88.90%); rural ( I 2 = 92.14%). Pooled estimates indicate a narrow difference in DR prevalence among people with diabetes in rural and urban India. The fast urbanization and increasing diabetes prevalence in rural areas underscore the need for providing equitable eye care at the bottom of the health pyramid.

Knowledge, attitude, and practice of diabetes in patients with and without sight-threatening diabetic retinopathy from two secondary eye care centres in India

“…On comparing the two centres, STDR was present in 21.7% of all the participants with differences between the recruitment centres (Darjeeling, 16% and Chennai, 27%). Signi cant geographical variation of DR in India has been reported which is associated with a number of variables including variable healthseeking behaviour, and access to healthcare services (19). The higher percentage of STDR in Chennai may be due to the fact that Sankara Nethralaya Eye Hospital in Chennai is one of the largest tertiary care referral hospitals not just for the south-eastern region but also for the whole of India and South Asia possibly attracting people with worse retinopathy pro les, whereas Kurseong sub-divisional hospital in Darjeeling is a secondary care referral hospital.…”

Relationship between Diabetic Nephropathy and Development of Diabetic Macular Edema in Addition to Diabetic Retinopathy

“…We consulted previous systemic reviews to examine DR prevalence in patients with type 2 diabetes in a general cohort [78][79][80][81][82][83] (Table 11). The global DR prevalence was 22.2-34.6% [78][79][80], but those of China and India were lower [81,82].…”

“…We consulted previous systemic reviews to examine DR prevalence in patients with type 2 diabetes in a general cohort [78][79][80][81][82][83] (Table 11). The global DR prevalence was 22.2-34.6% [78][79][80], but those of China and India were lower [81,82]. The DR prevalence in this study was high, presumably because it included patients who were referred for the purpose of assessment and treatment of DR.…”

Knowledge, attitude, and practice of diabetes in patients with and without sight-threatening diabetic retinopathy from two secondary eye care centres in India

“…A recent study in individuals with diabetes over the age of 40 years estimated the national prevalence of any form of DR to be 12·5%, and sight-threatening DR to be 4% [ 14 ]. In individuals aged 50 years or above, a higher prevalence of DR (17%) was reported with a narrow difference between rural (14%) and urban (17.4%) settings [ 15 , 16 ]. Studies conducted in patients attending tertiary care hospitals suggest a range of DR that varied between 32%-63% [ 17 , 18 ].…”