Visual impairment due to diabetic retinopathy decreasing even as diabetes cases rise
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Despite an increasing prevalence of diabetes, both the prevalence and incidence of visual impairment caused by diabetic retinopathy have fallen and shifted to older age, according to 40-year data from Finland.
“A significant number of patients with type 2 diabetes consider loss of vision the worst complication of the disease,” Petri K.M. Purola, MSc, a doctoral researcher in the Faculty of Medicine and Health Technology at Tampere University in Finland, and colleagues wrote in study background. “As the number and life expectancy of people living with diabetes increases in the future, the number of people with diabetic retinopathy and, consequently, visual impairment is expected to rapidly rise. Hence, there is a significant need for evaluating the changes in visual impairment due to diabetic retinopathy over time for public health issues and response.”
The researchers assessed data from the Finnish national register collected from 1986 to 2019 to identify changes in incidence, prevalence, severity and age of onset of visual impairment due to diabetic retinopathy and compare those changes with trends in diabetes screening and treatment.
The study included patients with visual impairment with nonproliferative diabetic retinopathy (NPDR; n = 2,490; 73% women) or proliferative diabetic retinopathy (PDR; n = 2,026, 53% women) from 1980 to 2019 in the Finnish Register of Visual Impairment; these conditions served as the main diagnosis for visual impairment. Researchers acquired the number of patients treated for type 1 or type 2 diabetes from 1986 to 2019 from the Social Insurance Institution of Finland registers based on reimbursed medication data.
Data revealed a decrease in the annual incidence of reported visual impairment since its peak in the 1990s. Specifically, between the 1990s and 2010s, NPDR dropped from 102.3 to 5.5 per 100,000 treated patients with diabetes, and PDR fell from 39.9 to 7.4 per 100,000, whereas the incidence of people with diabetes treated for diabetic retinopathy rose.
Moreover, the annual prevalence of reported visual impairment and sex-based differences progressively decreased in the 2000s and 2010s. Researchers also found that reported visual impairment severity fell as well, whereas the age at the reported visual impairment onset rose during the 40 years.
“These positive and encouraging trends underline the importance of efficient screening and timely treatment of diabetes and diabetic retinopathy,” researchers wrote. “In the future, more population-based studies with long follow-up periods in other countries could explore the situation in different regions of the world.”
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