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Incidence and progression of diabetic retinopathy: a systematic review

Published on Feb 1, 2019in The Lancet Diabetes & Endocrinology 19.31
· DOI :10.1016/S2213-8587(18)30128-1
Charumathi Sabanayagam28
Estimated H-index: 28
(National University of Singapore),
Riswana Banu + 11 AuthorsTien Wong118
Estimated H-index: 118
Summary Diabetic retinopathy is a leading cause of vision impairment and blindness. We systematically reviewed studies published from Jan 1, 1980, to Jan 7, 2018, assessed the methodological quality, and described variations in incidence of diabetic retinopathy by region with a focus on population-based studies that were conducted after 2000 (n=8, including two unpublished studies). Of these eight studies, five were from Asia, and one each from the North America, Caribbean, and sub-Saharan Africa. The annual incidence of diabetic retinopathy ranged from 2·2% to 12·7% and progression from 3·4% to 12·3%. Progression to proliferative diabetic retinopathy was higher in individuals with mild disease compared with those with no disease at baseline. Our Review suggests that more high-quality population-based studies capturing data on the incidence and progression of diabetic retinopathy with stratification by age and sex are needed to consolidate the evidence base. Our data is useful for conceptualisation and development of major public health strategies such as screening programmes for diabetic retinopathy.
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Published on Sep 1, 2016in Pediatric Diabetes 3.17
Nan-Kai Wang16
Estimated H-index: 16
(Chang Gung University),
Chi-Chun Lai23
Estimated H-index: 23
(Chang Gung University)
+ 6 AuthorsFu-Sung Lo1
Estimated H-index: 1
(Chang Gung University)
Background The aim of this study was to examine risk factors associated with the development of diabetic retinopathy (DR) 10 yr after the diagnosis of juvenile-onset type 1 diabetes in Taiwan. Methods This retrospective cohort study of 153 individuals with type 1 diabetes for >10 yr duration (mean duration: 13.1 yr) included participants in the Chang Gung Juvenile Diabetes Eye Study. Risk factors assessed for association with DR included age, gender, age at onset and duration of diabetes, self-r...
4 Citations Source Cite
Published on Sep 1, 2003in Ophthalmology 7.48
Charles P. Wilkinson6
Estimated H-index: 6
(Greater Baltimore Medical Center),
Frederick L. Ferris66
Estimated H-index: 66
(National Institutes of Health)
+ 7 AuthorsJuan Verdaguer T.3
Estimated H-index: 3
(University of Chile)
Abstract Purpose To develop consensus regarding clinical disease severity classification systems for diabetic retinopathy and diabetic macular edema that can be used around the world, and to improve communication and coordination of care among physicians who care for patients with diabetes. Design Report regarding the development of clinical diabetic retinopathy disease severity scales. Participants A group of 31 individuals from 16 countries, representing comprehensive ophthalmology, retina sub...
1,202 Citations Source Cite
Published on Feb 1, 1989in Archives of Ophthalmology
Ronald Klein164
Estimated H-index: 164
B.E. K. Klein149
Estimated H-index: 149
+ 2 AuthorsDavid L. DeMets70
Estimated H-index: 70
• The four-year incidence and progression of retinopathy were investigated in a population-based sample of people with diabetes diagnosed at 30 years of age or older. For insulin users, 73 (47%) of the 154 who did not have any retinopathy at the first visit developed it in the four-year interval, and 31 (7%) of the 418 free of proliferative retinopathy developed it. Worsening of retinopathy occurred in a total of 34% (142/418). For nonusers of insulin, corresponding rates were 34% (110/320) for ...
246 Citations Source Cite
Published on May 1, 2010in American Journal of Ophthalmology 4.79
Rohit Varma56
Estimated H-index: 56
(University of Southern California),
Farzana Choudhury13
Estimated H-index: 13
(University of Southern California)
+ 3 AuthorsStanley P. Azen76
Estimated H-index: 76
(University of Southern California)
Purpose To estimate the 4-year incidence and progression of diabetic retinopathy, macular edema (ME) and clinically significant macular edema (CSME) among adult Latinos with diabetes mellitus. Design A population-based, longitudinal study of 4658 self-identified Latinos (primarily Mexican Americans), residing in Los Angeles, examined at baseline (2000–2003) and at 4 years (2004–2008). Methods Participants underwent a standardized ophthalmic examination. Diabetic retinopathy (DR) and CSME were de...
44 Citations Source Cite
Published on Dec 1, 2009in Diabetes Care 13.40
Tien Wong118
Estimated H-index: 118
(University of Melbourne),
Mkaya Mwamburi13
Estimated H-index: 13
(Tufts University)
+ 7 AuthorsPaul M. Matthews159
Estimated H-index: 159
(University of Sydney)
OBJECTIVE This meta-analysis reviews rates of progression of diabetic retinopathy to proliferative diabetic retinopathy (PDR) and/or severe visual loss (SVL) and temporal trends. RESEARCH DESIGN AND METHODS This systematic literature review and meta-analysis of prospective studies assesses progression of retinopathy among diabetic patients without treatment for retinopathy at baseline. Studies published between 1975 to February 2008 were identified. Outcomes of interest were rates of progression...
114 Citations Source Cite
Published on Apr 1, 1994in Diabetic Medicine 3.13
Elisabet Agardh32
Estimated H-index: 32
Carl-David Agardh43
Estimated H-index: 43
+ 1 AuthorsOle Torffvit27
Estimated H-index: 27
Out of 369 diabetic patients with an age at onset of diabetes > or = 30 years previously studied, 325 (88%) were included in an ophthalmological follow-up examination 4 years later. In patients treated with oral drugs at baseline, the incidence of any type of retinopathy was 30.8% and of severe retinopathy 5.7%. All patients who developed severe retinopathy received insulin during the follow-up period. At baseline, duration of diabetes, diastolic blood pressure, and signs of nephropathy (p < 0.0...
34 Citations Source Cite
Published on Jun 1, 2007in American Journal of Ophthalmology 4.79
Tien Wong118
Estimated H-index: 118
(University of Melbourne),
Ronald Klein164
Estimated H-index: 164
(University of Wisconsin-Madison)
+ 5 AuthorsA. R. Sharrett86
Estimated H-index: 86
(Johns Hopkins University)
Retinopathy signs (e.g., single microaneurysm, retinal hemorrhage, and/or cotton wool spots) are common fundus findings in older people, even in those without diabetes.1, 2 Recent population-based studies show that among non-diabetic persons aged 40 years and older, up to 10% may have some retinopathy signs as detected from fundus photographs.3-6 Although their underlying pathophysiology remains uncertain, these retinopathy signs have been shown to be a risk marker of subclinical cerebrovascular...
45 Citations Source Cite
Paul M. Matthews159
Estimated H-index: 159
A prevalence study of diabetic eye disease was conducted in Newcastle during 1977–1978. Ophthalmoscopic retinopathy was found in 49% of 1210 clinic diabetics, while vision-threatening retinopathy (VTR) (proliferative signs or maculopathy) occurred in 13%. Maculopathy was the commonest cause of visual loss, occurring frequently in subjects with non-insulin-dependent diabetes. This group has now been followed for up to seven years (including 70% at four years); incidence rates for the development ...
37 Citations Source Cite
Published on Aug 18, 2009in Annals of Internal Medicine 19.38
David Moher122
Estimated H-index: 122
(Ottawa Hospital Research Institute),
Alessandro Liberati44
Estimated H-index: 44
(University of Birmingham)
+ 1 AuthorsDouglas G. Altman193
Estimated H-index: 193
(University of Oxford)
7,617 Citations Source Cite
Published on Jan 1, 1998in Diabetes Care 13.40
Stephanie M Tudor1
Estimated H-index: 1
Richard F. Hamman73
Estimated H-index: 73
+ 2 AuthorsSusan Shetterly32
Estimated H-index: 32
OBJECTIVE To learn if Hispanic people with type 2 diabetes have excess incidence and/or progression of diabetic retinopathy and to explore the association of risk factors with diabetic retinopathy. RESEARCH DESIGN AND METHODS There were 244 subjects with type 2 diabetes (65.3% Hispanic) with at least one follow-up visit between 1984 and 1992 examined for the development of retinopathy over a median of 4.8 years (range 2.0−6.6 years). Stereo fundus photos were graded by the University of Wisconsi...
45 Citations Source Cite
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