Diabetic retinopathy projected to increase more than 50% by 2045
Global incidence of diabetic retinopathy, vision-threatening diabetic retinopathy and clinically significant macular edema is projected to rise through 2045, according to a study in Ophthalmology.
“A previous meta-analysis on the global prevalence of [diabetic retinopathy (DR)] was conducted more than a decade ago using data up to 2008 from 35 population-based studies,” Zhen Ling Teo, MBBS, MRCS, of the Singapore National Eye Centre, and colleagues wrote. “A need exists for contemporary data because several important changes regarding the epidemiologic features of DR have emerged in recent years.”
To provide updated estimates of global DR prevalence, Teo and colleagues conducted a systemic review and meta-analysis of population-based studies found on PubMed, Medline, Web of Science, Scopus and the Asian Eye Consortium that focused on the prevalence of DR, vision-threatening diabetic retinopathy (VTDR) and clinically significant macular edema (CSME).
Researchers evaluated 59 studies and found that among individuals with diabetes the prevalence as of March 2020 was 22.27% for DR, 6.17% for VTDR and 4.07% for CSME.
Using population data from the International Diabetes Federation, researchers estimated that the number of adults with DR is projected to increase from 103.12 million in 2020 to 160.5 million in 2045, while cases of VTDR are expected to rise from 28.54 million to 44.82 million, and cases of CSME from 18.83 million to 28.61 million.
Researchers also observed that Africa (35.9%) and North America and the Caribbean (33.3%) had the greatest DR prevalence, while South and Central America had the overall lowest (13.37%). Further, they found Hispanic people had the highest DR prevalence at 47.4%, while people of African descent had the highest VTDR prevalence at 10.9%. Middle Easterners had the highest prevalence of CSME at 6.06%.
“Our findings suggest that approximately one in five persons with diabetes worldwide have DR,” Teo and colleagues concluded. “Although the current prevalence estimates for VTDR are lower than earlier estimates, the total number of people losing vision as a result of DR may continue to rise. ... Findings and estimates from this study may aid in the planning of global, regional and country-specific health care strategies to prevent diabetes-related vision loss.”
Perspective
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DR is the most common complication of diabetes mellitus (DM) and is a leading cause of blindness in adults age 20 to 74 years. Several global factors have led to an increased risk of developing DR. These include a rapidly aging global population, increase in lifespan for those living with DM and changes in lifestyle that increase the risk for DM. As such, it is expected that the demand for eye care and the burden of DR will increase in coming years.
The authors of this study conducted a systematic review and meta-analysis of 59 population-based studies to provide contemporary global prevalence of DR and offer future projections of the number of individuals with DR, VTDR and CSME through 2045. The findings suggest a global prevalence of 22.7% for DR, 6.17% for VTDR and 4.07% for CSME. In addition, this study demonstrates regional and ethnic variations in prevalence, with the North America/Caribbean and Middle East/North Africa regions having significantly higher rates of DR than other regions. The authors estimated that the number of individuals with DR will increase by 55.6% in 2024.
This study highlights the importance of access to eye care for the millions of individuals living with DM. The results can be used in the planning of specific health care strategies to address this growing population. As eye care providers, we must make regular eye exams for our diabetic patients a top priority to prevent diabetes-related vision loss.
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