Global and Regional Prevalence of Diabetic Retinopathy; A Comprehensive Systematic Review and Meta-analysis

Hashemi, Hassan; Rezvan, Farhad; Pakzad, Reza; Ansaripour, Asal; Heydarian, Samira; Yekta, Abbasali; Ostadimoghaddam, Hadi; Pakbin, Mojgan; Khabazkhoob, Mehdi

doi:10.1080/08820538.2021.1962920

Cited by 22 publications

(16 citation statements)

References 119 publications

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“…However, Wong et al [ 20 ] and Park et al [ 21 ] e the prevalence of DR in male was 47.3% and 48.3%, respectively. Various studies found that the prevalence of DR increased with age due to longer exposure to hyperglycemia[ 18 , 22 , 23 ], which is consistent with our result. It was estimated that nearly 80% of those with diabetes live in low- and middle-income countries [ 24 ].…”

Section: Discussionsupporting

confidence: 93%

Biscuit consumption and diabetic retinopathy incidence in adults in the United States

Shi

Chen

Zhu

et al. 2022

Diabetol Metab Syndr

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Background Foods have a considerable influence on human health and were directly related to glycemic control for diabetes patients. However, little is known about the effects of biscuits, a traditional food consumed in large amounts in several countries, on diabetic retinopathy. This study aimed to explore the association between biscuit consumption and diabetic retinopathy prevalence in adults of the United States population. Methods A cross-sectional study with 1904 participants from the National Health and Nutrition Examination Survey database were included in this population-based, cross-sectional study. The association between different consumption frequencies of biscuit and diabetic retinopathy prevalence was evaluated using a binary logistic regression model. Trend test, stratified and interaction analyses were also performed. Results After possible confounders including sex, age, ethnicity, education, marital status, family poverty income ratio, smoking and alcohol consumption habit, fasting blood glucose level, hemoglobin A1c level, diagnosis of diabetes, insulin use, blood pressure, body mass index were adjusted, the participants who consumed biscuit 1–11 times a year, 1–3 times a month, and more than once a week had a 139.8% (95% confidence interval, 1.003–5.734), 182.1% (95% confidence interval, 1.106–7.191), and 236.2% (95% confidence interval, 1.335–9.844) higher risk of diabetic retinopathy prevalence, respectively, compared with those who never ate biscuit. For male, non-Hispanic, and overweight (body mass index ≥ 25 kg/m2) subgroups, the trend test demonstrated that the diabetic retinopathy prevalence significantly elevated with increased frequency of biscuit consumption (Ptrend = 0.021, 0.009, and 0.002, respectively). The interaction analysis suggested that no aforementioned confounders played an interactive role in the relationship between biscuit consumption and diabetic retinopathy prevalence. Conclusions The risk of diabetic retinopathy was positively associated with biscuit consumption. Moreover, for male, non-Hispanic, or overweight individuals, the risk of diabetic retinopathy significantly increased with the frequency of biscuit consumption.

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Section: Discussionsupporting

confidence: 93%

Biscuit consumption and diabetic retinopathy incidence in adults in the United States

Shi

Chen

Zhu

et al. 2022

Diabetol Metab Syndr

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“…Despite the advances in optimal control of systemic risk factors, i.e., hyperglycemia, hypertension and hyperglycemia, and the application of anti-vascular endothelial growth factor (VEGF) agents (Anti-VEGF), the prevalence of DR remains high in diabetic patients. Among diabetic patients, about one third of patients suffered from DR, which increases markedly after the age of 60 years due to the longer duration of diabetes [ 1 ]. A comprehensive systematic review and meta-analysis showed that the estimated pooled prevalence of DR was 28.41% (95% CI: 25.98 to 30.84), 25.93% (95% CI: 23.54 to 28.31), and 28.95% (95% CI: 26.57 to 31.32) in the diabetic population in general, in female, and in male, respectively; with no inter-gender difference for DR prevalence [ 1 ].…”

Section: Overview Of Diabetic Retinopathy (Dr) and Diabetic Macular E...mentioning

confidence: 99%

Diabetic Macular Edema: Current Understanding, Molecular Mechanisms and Therapeutic Implications

Zhang

Zhang²,

Zhang

et al. 2022

Cells

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Diabetic retinopathy (DR), with increasing incidence, is the major cause of vision loss and blindness worldwide in working-age adults. Diabetic macular edema (DME) remains the main cause of vision impairment in diabetic patients, with its pathogenesis still not completely elucidated. Vascular endothelial growth factor (VEGF) plays a pivotal role in the pathogenesis of DR and DME. Currently, intravitreal injection of anti-VEGF agents remains as the first-line therapy in DME treatment due to the superior anatomic and functional outcomes. However, some patients do not respond satisfactorily to anti-VEGF injections. More than 30% patients still exist with persistent DME even after regular intravitreal injection for at least 4 injections within 24 weeks, suggesting other pathogenic factors, beyond VEGF, might contribute to the pathogenesis of DME. Recent advances showed nearly all the retinal cells are involved in DR and DME, including breakdown of blood-retinal barrier (BRB), drainage dysfunction of Müller glia and retinal pigment epithelium (RPE), involvement of inflammation, oxidative stress, and neurodegeneration, all complicating the pathogenesis of DME. The profound understanding of the changes in proteomics and metabolomics helps improve the elucidation of the pathogenesis of DR and DME and leads to the identification of novel targets, biomarkers and potential therapeutic strategies for DME treatment. The present review aimed to summarize the current understanding of DME, the involved molecular mechanisms, and the changes in proteomics and metabolomics, thus to propose the potential therapeutic recommendations for personalized treatment of DME.

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“…Systematic reviews and meta-analyses have shown a pooled prevalence of NPDR of 15.1% in patients with diabetes and 27% in patients with type 2 diabetes [ 7 , 8 ]. In a recent comprehensive review based on 90 studies with 204,189 patients with diabetes, a prevalence of NPDR of 24.8% was reported [ 9 ]. Approximately half of the patients with severe NPDR will progress to PDR within a year [ 4 ], so the prevention of disease progression to more advanced stages with potential visual loss and the identification of people at high risk of progression and greatest potential to benefit from treatment is of the utmost importance.…”

Section: Introductionmentioning

confidence: 99%

Supplementation with a Highly Concentrated Docosahexaenoic Acid (DHA) in Non-Proliferative Diabetic Retinopathy: A 2-Year Randomized Double-Blind Placebo-Controlled Study

García¹,

Martínez²,

López³

et al. 2022

Antioxidants

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We assessed the effect of a 2-year supplementation with a highly concentrated docosahexaenoic acid (DHA) product with antioxidant activity on non-proliferative diabetic retinopathy (NPDR) in a randomized double-blind placebo-controlled study. A total of 170 patients with diabetes were randomly assigned to the DHA group (n = 83) or the placebo group (n = 87). NPDR was diagnosed using non-contact slit lamp biomicroscopy examination, and classified into mild, moderate, and severe stages. Patients in the DHA group received a high rich DHA triglyceride (1050 mg/day) nutritional supplement, and those in the placebo group received olive oil capsules. The percentages of mild NPDR increased from 61.7% at baseline to 75.7% at the end of the study in the DHA group, and from 61.9% to 73.1% in the placebo group. Moderate NPDR stages decreased from 35.1% at baseline to 18.7% at the end of the study in the DHA group, and from 36.8% to 26.0% in the placebo group. In the DHA group, there were five eyes with severe NPDR at baseline, which increased to one more at the end of the study. In the placebo group, of two eyes with severe NPDR at baseline, one eye remained at the end of the study. Changes in visual acuity were not found. There were improvements in the serum levels of HbA1c in both groups, but significant differences between the DHA and the placebo groups were not found. In this study, the use of a DHA triglyceride nutraceutical supplement for 2 years did not appear to influence the slowing of the progression of NPDR.

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Global and Regional Prevalence of Diabetic Retinopathy; A Comprehensive Systematic Review and Meta-analysis

Cited by 22 publications

References 119 publications

Biscuit consumption and diabetic retinopathy incidence in adults in the United States

Biscuit consumption and diabetic retinopathy incidence in adults in the United States

Diabetic Macular Edema: Current Understanding, Molecular Mechanisms and Therapeutic Implications

Supplementation with a Highly Concentrated Docosahexaenoic Acid (DHA) in Non-Proliferative Diabetic Retinopathy: A 2-Year Randomized Double-Blind Placebo-Controlled Study

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