Global Prevalence of Diabetic Retinopathy and Projection of Burden through 2045

Teo, Zhen Ling; Tham, Yih‐Chung; Yu, Marco; Chee, Miao Li; Rim, Tyler Hyungtaek; Cheung, Ning; Бикбов, М.М.; Wang, Ya Xing; Tang, Yanlin; Lü, Yi; Wong, Ian Y.; Ting, Daniel Shu Wei; Tan, Gavin Siew Wei; Jonas, Jost B.; Sabanayagam, Charumathi; Wong, Tien Yin; Cheng, Ching-Yu

doi:10.1016/j.ophtha.2021.04.027

Cited by 1,103 publications

(739 citation statements)

References 45 publications

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“…Diabetes mellitus currently represents one of the emerging threats to public health all over the world, and diabetic retinopathy (DR) is a cause of visual impairment and blindness in the world [1]. Retinal microvascular damage has been considered the main pathophysiological driver of retinal damage induced by diabetes, including endothelial cell damage, pericyte loss, and secondary breakdown of the blood-retinal barriers [2].…”

Section: Introductionmentioning

confidence: 99%

Early Microvascular and Oscillatory Potentials Changes in Human Diabetic Retina: Amacrine Cells and the Intraretinal Neurovascular Crosstalk

Midena

Torresin

Longhin

et al. 2021

JCM

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To analyze the early microvascular retinal changes and oscillatory potentials alterations secondary to diabetic retinal damage, 44 eyes of 22 diabetic patients without and with mild diabetic retinopathy (DR) and 18 eyes of 9 healthy controls were examined. All subjects underwent spectral domain optical coherence tomography (SD-OCT), OCT angiography (OCTA), and electroretinography of oscillatory potentials (OPs). At OCTA, vessel area density (VAD), vessel length fraction (VLF), and fractal dimension (FD) were significantly reduced in the superficial vascular plexus (SVP), VLF and FD in the intermediate capillary plexus (ICP), and FD in the deep capillary plexus (DCP) in the diabetic group compared to the control group. The amplitude (A) of OP2, OP3, OP4 and the sum of OPs were significantly reduced in the diabetic group versus the controls, and the last two parameters were reduced also in patients without DR versus the controls. Moreover, in the diabetic group, a significant direct correlation was found between the A of OP1, OP2, OP3 and sOP and the VLF and FD in the SVP, while a statistically significant inverse correlation was found between the A of OP3 and OP4 and the VDI in the ICP and DCP. The reduced oscillatory potentials suggest a precocious involvement of amacrine cells in diabetic eyes, independently of DR presence, and their correlation with vascular parameters underlines the relevance of the crosstalk between these cells and vascular components in the pathophysiology of this chronic disease.

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Section: Introductionmentioning

confidence: 99%

Early Microvascular and Oscillatory Potentials Changes in Human Diabetic Retina: Amacrine Cells and the Intraretinal Neurovascular Crosstalk

Midena

Torresin

Longhin

et al. 2021

JCM

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“…In addition, in year 2020, the number of adults worldwide with DR, and vision-threatening DR was estimated to be 103.12 million, and 28.54 million. By the year 2045, the numbers are projected to increase to 160.50 million, and 44.82 million [ 12 ]. In addition, in developing countries where there is a shortage of ophthalmologists [ 13 , 14 ] as well as access to standard clinical facilities.…”

Section: Introductionmentioning

confidence: 99%

Automated Detection and Diagnosis of Diabetic Retinopathy: A Comprehensive Survey

et al. 2021

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Diabetic Retinopathy (DR) is a leading cause of vision loss in the world. In the past few years, artificial intelligence (AI) based approaches have been used to detect and grade DR. Early detection enables appropriate treatment and thus prevents vision loss. For this purpose, both fundus and optical coherence tomography (OCT) images are used to image the retina. Next, Deep-learning (DL)-/machine-learning (ML)-based approaches make it possible to extract features from the images and to detect the presence of DR, grade its severity and segment associated lesions. This review covers the literature dealing with AI approaches to DR such as ML and DL in classification and segmentation that have been published in the open literature within six years (2016–2021). In addition, a comprehensive list of available DR datasets is reported. This list was constructed using both the PICO (P-Patient, I-Intervention, C-Control, O-Outcome) and Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) 2009 search strategies. We summarize a total of 114 published articles which conformed to the scope of the review. In addition, a list of 43 major datasets is presented.

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“…Of note, in the USA approximately 30% of adult patients with diabetes are found to have some form of DR and almost 3% diabetic macular edema (DME), which can occur at any stage of DR [7]. According to a recent meta-analysis, in 2020 the number of adults worldwide with DR was estimated to be 103 million and is projected to increase to 160.5 million by 2045 [8]. nopathy (DR) is the most common microvascular complication of diabetes and is considered the leading cause of blindness in patients aged between 20 and 74 years [4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Intravitreal Anti-Vascular Endothelial Growth Factor Agents for the Treatment of Diabetic Retinopathy: A Review of the Literature

Chatziralli

Loewenstein

2021

Pharmaceutics

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Background: Diabetic retinopathy (DR) is the leading cause of blindness in the working-age population. The purpose of this review is to gather the existing literature regarding the use of the approved anti-vascular endothelial growth (anti-VEGF) agents in the treatment of DR. Methods: A comprehensive literature review in PubMed engine search was performed for articles written in English language up to 1 July 2021, using the keywords “diabetic retinopathy”, “ranibizumab”, “aflibercept”, and “anti-VEGF”. Emphasis was given on pivotal trials and recent robust studies. Results: Intravitreal anti-VEGF agents have been found to significantly improve visual acuity and reduce retinal thickness in patients with diabetic macular edema (DME) in a long-term follow-up ranging from 1 to 5 years and are considered the standard-of-care in such patients. Regarding DR, intravitreal anti-VEGF agents provided ≥2-step improvement in DR severity on color fundus photography in about 30–35% of patients with NPDR at baseline, in the majority of clinical trials originally designed to evaluate the efficacy of intravitreal anti-VEGF agents in patients with DME. Protocol S and CLARITY study have firstly reported that intravitreal anti-VEGF agents are non-inferior to panretinal photocoagulation (PRP) in patients with proliferative DR (PDR). However, the use of new imaging modalities, such as optical coherence tomography-angiography and wide-field fluorescein angiography, reveals conflicting results about the impact of anti-VEGF agents on the regression of retinal non-perfusion in patients with DR. Furthermore, one should consider the high “loss to follow-up” rate and its devastating consequences especially in patients with PDR, when deciding to treat the latter with intravitreal anti-VEGF agents alone compared to PRP. In patients with PDR, combination of treatment of intravitreal anti-VEGF agents and PRP has been also supported. Moreover, in the specific case of vitreous hemorrhage or tractional retinal detachment as complications of PDR, intravitreal anti-VEGF agents have been found to be beneficial as an adjunct to pars plana vitrectomy (PPV), most commonly given 3–7 days before PPV, offering reduction in the recurrence of vitreous hemorrhage. Conclusions: There is no general consensus regarding the use of intravitreal anti-VEGF agents in patients with DR. Although anti-VEGF agents are the gold standard in the treatment of DME and seem to improve DR severity, challenges in their use exist and should be taken into account in the decision of treatment, based on an individualized approach.

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Global Prevalence of Diabetic Retinopathy and Projection of Burden through 2045

Cited by 1,103 publications

References 45 publications

Early Microvascular and Oscillatory Potentials Changes in Human Diabetic Retina: Amacrine Cells and the Intraretinal Neurovascular Crosstalk

Early Microvascular and Oscillatory Potentials Changes in Human Diabetic Retina: Amacrine Cells and the Intraretinal Neurovascular Crosstalk

Automated Detection and Diagnosis of Diabetic Retinopathy: A Comprehensive Survey

Intravitreal Anti-Vascular Endothelial Growth Factor Agents for the Treatment of Diabetic Retinopathy: A Review of the Literature

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