Prevalence and incidence of diabetic retinopathy (DR) in the UK population of Gloucestershire

Scanlon, Peter H; Nevill, Clareece R; Stratton, I M; Maruti, Sonia S.; Massó-González, Elvira L; Sivaprasad, Sobha; Bailey, Clare; Ehrlich, Michael; Chong, Victor

doi:10.1111/aos.14927

Cited by 14 publications

(15 citation statements)

References 36 publications

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“…A total of 7,593 (0.4%) urgent referrals were due to PDR and 52,597 (2.5%) to pre-proliferative diabetic retinopathy or maculopathy [ 43 ]. Overall, prevalence of DR was assessed as being 36.6% and that of PDR was 3.1% in 2016 (analysed in a subpopulation of 35,873 diabetics screened within the Gloucestershire Diabetic Eye Screening Programme) [ 44 ].…”

Section: Dr: Global Statistics and Trendsmentioning

confidence: 99%

“…In addition, early diagnosis and management of DR are generally acknowledged as a key in reducing diabetes-related visual impairment [ 82 ]. For instance, following the implementation of a national screening program designed to identify vision-threatening DR, blindness from DR was significantly reduced in Iceland, England, and Wales [ 43 , 44 ].…”

Section: Targeted Mitigationmentioning

confidence: 99%

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Diabetic retinopathy as the leading cause of blindness and early predictor of cascading complications—risks and mitigation

et al. 2023

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Proliferative diabetic retinopathy (PDR) the sequel of diabetic retinopathy (DR), a frequent complication of diabetes mellitus (DM), is the leading cause of blindness in the working-age population. The current screening process for the DR risk is not sufficiently effective such that often the disease is undetected until irreversible damage occurs. Diabetes-associated small vessel disease and neuroretinal changes create a vicious cycle resulting in the conversion of DR into PDR with characteristic ocular attributes including excessive mitochondrial and retinal cell damage, chronic inflammation, neovascularisation, and reduced visual field. PDR is considered an independent predictor of other severe diabetic complications such as ischemic stroke. A “domino effect” is highly characteristic for the cascading DM complications in which DR is an early indicator of impaired molecular and visual signaling. Mitochondrial health control is clinically relevant in DR management, and multi-omic tear fluid analysis can be instrumental for DR prognosis and PDR prediction. Altered metabolic pathways and bioenergetics, microvascular deficits and small vessel disease, chronic inflammation, and excessive tissue remodelling are in focus of this article as evidence-based targets for a predictive approach to develop diagnosis and treatment algorithms tailored to the individual for a cost-effective early prevention by implementing the paradigm shift from reactive medicine to predictive, preventive, and personalized medicine (PPPM) in primary and secondary DR care management.

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Section: Dr: Global Statistics and Trendsmentioning

confidence: 99%

Section: Targeted Mitigationmentioning

confidence: 99%

Diabetic retinopathy as the leading cause of blindness and early predictor of cascading complications—risks and mitigation

et al. 2023

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“…This is higher than the global prevalence (34.6%) [ 25 ]. We reported a higher prevalence of DR compared to North America, the UK, Italy, China and Germany (33.3%, 36.6% 27.6%, 27.9%and 25.8%, respectively) [ 26 , 27 , 28 , 29 , 30 ]. On the other hand, we reported a lower DR prevalence compared to France and Norway (50.1% and 61%, respectively) [ 31 , 32 ].…”

Section: Discussionmentioning

confidence: 98%

Clinical and Molecular Characteristics of Diabetic Retinopathy and Its Severity Complications among Diabetic Patients: A Multicenter Cross-Sectional Study

Zabadi

Taha

Zagha

2022

JCM

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Background: Diabetic retinopathy (DR) is a complication associated with uncontrolled DM. It is a leading preventable cause of visual impairment in the world and a cause of blindness in those under 75 years old in developing countries. We aimed to explore the prevalence and associated risk factors of DR among diabetic patients in the West Bank. Materials and Methods:A quantitative multicenter cross-sectional study was conducted in all West Bank cities. Nearly, 385 patients underwent a comprehensive eye examination in addition to blood and urine tests. A previously validated questionnaire for ocular examination classification was used together with a socio-demographic and past medical history information sheet. Results: The prevalence of all DR in the West Bank was 41.8%. The prevalence of non-proliferative diabetic retinopathy (NPDR) was 50.3% (38.5% for mild NPDR, 10.6% for moderate NPDR and 1.2% for severe NPDR). The prevalence of proliferative diabetic retinopathy (PDR) was 9.9% and 39.7% for diabetic macular edema (DME) (17.4% for mild, 15.5% for moderate and 6.8% for severe DME). The prevalence of vision-threatening PDR and DME was 49.7% for both. In a univariate analysis, DR was significantly associated with body mass index; BMI (p = 0.035), DM duration (p = 0.002), Low-density lipoprotein (LDL) (p = 0.034), glutamic-oxaloacetic transaminase (GOT) level (p = 0.016) andblood urea (BU) (p = 0.044). A multivariate analysis showed a strong significant association between DR andpatients who had DM for 10-19years (adjusted odds ratio; AOR (95%CI); 1.843 (1.05–3.22)), abnormal levels of LDL (AOR (95%CI); 0.50 (0.30–0.83)), abnormal levels of GOT (AOR (95%CI); 0.49 (0.27–0.89)), and overweight (AOR (95%CI); 0.39 (0.19–0.80)). Conclusions: We found that the prevalence of DR in Palestine was higher than the global prevalence. Referral coordination between ophthalmologists and internal physicians is necessary to better follow up with DR patients. An interventional educational program by clinicians and public health professionals is recommended.

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“…A UK retrospective cohort analysis found that 46% of those with newly diagnosed Type 2 diabetes who were retinopathy‐free developed DR after 7 years 22 . This study used the Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC) database and ascertained DR status using diagnosis codes, 22 although the validity of the database is unclear, particularly regarding those without DR. Another UK population‐based study reported an 8.5% annual incidence of new DR in 2016 in those with Type 2 diabetes using electronic medical records 6 . In a review of population‐based studies of Type 1 and/or Type 2 diabetes conducted after 2000, the annual incidence of DR ranged from 2.2% to 12.7% 5 .…”

Section: Discussionmentioning

confidence: 99%

“…These observations suggested a substantial lifetime DR risk but this may no longer apply given temporal trends in other complications. A recent review showed that the incidence of DR in people with Type 2 diabetes was lower in studies conducted after versus before 2000, 5 and a UK study showed a significant decrease in the incidence of DR between 2013 and 2016 6 . Furthermore, the global prevalence of DR appears to have decreased from 34.6% in a pooled analysis of studies conducted between 1980 and 2008 7 to 22.2% in a more recent analysis in which studies up to 2020 were included 8 .…”

Section: Introductionmentioning

confidence: 99%

Retinopathy prevalence, incidence and trajectories in type 2 diabetes: The Fremantle diabetes study phase II

et al. 2022

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Aims To determine diabetic retinopathy (DR) prevalence, incidence, and whether distinct trajectories are associated with DR‐complicating Type 2 diabetes. Methods Retinal photographs from Fremantle Diabetes Study Phase II (FDS2) participants with Type 2 diabetes recruited in 2008–2011 and who attended biennial assessments for up to 6 years were graded as no DR, mild non‐proliferative DR (NPDR), moderate NPDR or severe NPDR/proliferative DR. Baseline DR prevalence, and the cumulative incidence of moderate NPDR or worse in those without DR at baseline, were calculated. Group‐based DR trajectory modelling was performed. Logistic regression determined independent associates of incident moderate NPDR or worse and trajectory group membership. Results Of 1521 participants (mean age 65.6 years, 52.1% males, median diabetes duration 9.0 years; 98% of all FDS2 participants with Type 2 diabetes) with gradable baseline photographs, 563 (37.0%) had DR. During a median 6.1 years of follow‐up, 23 (3.2%) without baseline DR developed at least moderate NPDR (crude incidence 6.1/1000 person‐years) with HbA1c the sole independent predictor (odds ratio [95% CI]: 1.62 [1.30–2.02] per 1% [11 mmol/mol] increase). Trajectory analysis showed two distinct groups, those with baseline/persistent DR (20%) and those remaining DR free (80%). Longer diabetes duration, insulin use, higher mean HbA1c, higher mean systolic blood pressure and higher mean urinary albumin: creatinine ratio all increased the odds (p ≤ 0.014) of being in the persistent DR trajectory group. Conclusions The low incidence of at least moderate NPDR reflects the trajectory analysis. The currently recommended biennial retinal screening frequency for individuals without DR could potentially be extended.

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Prevalence and incidence of diabetic retinopathy (DR) in the UK population of Gloucestershire

Cited by 14 publications

References 36 publications

Diabetic retinopathy as the leading cause of blindness and early predictor of cascading complications—risks and mitigation

Diabetic retinopathy as the leading cause of blindness and early predictor of cascading complications—risks and mitigation

Clinical and Molecular Characteristics of Diabetic Retinopathy and Its Severity Complications among Diabetic Patients: A Multicenter Cross-Sectional Study

Retinopathy prevalence, incidence and trajectories in type 2 diabetes: The Fremantle diabetes study phase II

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