Trends in the Prevalence and Progression of Diabetic Retinopathy Associated with Hyperglycemic Disorders during Pregnancy in Japan

Abstract

The aim of this study was to determine the prevalence and progression of diabetic retinopathy (DR) with hyperglycemic disorders during pregnancy (HDPs) in Japan between 2013 and 2018 using two cohorts. The patients with HDPs were classified as those with pre-existing DM (pexD), gestational DM (GDM), and overt DM (ODM). Cohort 1 was obtained from the health claims database whose diseases were classified by the International Classification of Diseases-10. Cohort 2 was derived from a retrospective, multicenter analysis of the medical records of 225 patients from 10 ophthalmological institutions. In Cohort 1, there were 5268 patients with an HDP prevalence of 8.4%. Among them, 73 of 1139 patients had pexD (6.4%) and 61 of 4129 patients with GDM (1.5%) had DR; the overall prevalence of DR was 2.5%. In Cohort 2, 36 of 225 patients (16.0%) had DR, and 149 patients were followed at the early and late stages of pregnancy. Moreover, 10 of the 102 patients with pexD (9.8%) and two of five patients with ODM (40.0%) had a progression of DR. In conclusion, the prevalence and progression of DR in patients with pexD is lower than previously reported. More attention should be given to pexD and ODM.

Variations in Electronic Health Record-Based Definitions of Diabetic Retinopathy Cohorts

“…After screening for lack of relevance (N = 28 articles) and applying our exclusion criteria, (N = 109), 42 articles were included in this study ( Fig 1 ). Table 3 8 , 9 , 10 , 11 , 12 , 13 , 14 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 lists the included studies (N = 42) in this literature review. The articles included published studies from 2008 to 2022.…”

“…A few studies also included complications of DR in their ICD-10 inclusion criteria, including neovascular glaucoma (H40.x) and vitreous hemorrhage (H43.1). 10 , 44 , 58 One study also chose to include various degrees of vision impairment (H54.x) in patients with known diabetes to identify their DR cohort. 49 The distribution of ICD-9 and ICD-10 codes is shown in Figure 3A and 3B respectively.…”

“… 1 Despite advances in DR treatments through clinical trials 3 and advances in DR telehealth screening, 4 , 5 there remain significant disparities in screening and treatment outcomes. 6 , 7 To address this gap in knowledge, retrospective studies have been crucial in advancing our understanding of epidemiologic differences, 8 , 9 , 10 treatment outcomes, 11 , 12 and health disparities. 13 , 14 …”

Correction: Sugimoto et al. Trends in the Prevalence and Progression of Diabetic Retinopathy Associated with Hyperglycemic Disorders during Pregnancy in Japan. J. Clin. Med. 2022, 11, 165

“…In the original publication [ 1 ], due to an editorial office error, there were mistakes in: “Table 1. The prevalence of DR from the Japanese claim database cohort; Table 2.…”