Nationwide trends and incidence of blindness in patients with diabetic retinopathy identified using an age-period-cohort analysis.

IF 2.8 3区医学 Q1 OPHTHALMOLOGY

Eye Pub Date : 2024-10-28 DOI:10.1038/s41433-024-03389-3

Ju-Yeun Lee, Kunho Bae, Sangjun Lee, Sue K Park

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引用次数: 0

Abstract

Objectives: To estimate the epidemiologic trends of blindness in patients with diabetic retinopathy (DR) and investigate the age-, period-, and cohort-specific effects on blindness.

Methods: A total of 2.5 million patients with DR aged 20 years or older were included from the Korean National Health Claims database from 2005 to 2019. Non-proliferative DR/ proliferative DR (NPDR/PDR) cohorts were constructed separately. Participants were identified as having a blindness in at least one eye. The incidence of blindness were calculated using a log-linear Poisson age-period-cohort (APC) analysis model, each effect on blindness were estimated for each study group.

Results: The incidence of blindness was 1326.62 per 100,000 in the NPDR group and 3397.57 in the PDR group. The blindness rate sharply decreased after 2011, with annual decreases of 5.6% and 4.4% in the NPDR and the PDR groups, respectively. People born between 1920 and 1930 had the highest overall risk of blindness, with the risk decreasing rapidly after that. For those born after 1980, the risk started to increase in both sexes. Among the APC models, the combination model of age, period, and cohort effects showed the highest explanatory power (0.96).

Conclusions: In this nationwide long-term study, blindness in DR was not due to a single epidemiologic cause but rather a combination of biological age, social determinants, and healthcare policies. The increased risk of blindness in individuals in their 20 s and 30 s may even increase in the future and should not be ignored. Therefore, vigilance of younger patients is recommended.

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利用年龄-时期-队列分析确定全国糖尿病视网膜病变患者的失明趋势和发病率。

目的估算糖尿病视网膜病变（DR）患者失明的流行病学趋势，并研究特定年龄、时期和队列对失明的影响：方法：2005 年至 2019 年期间，韩国国民健康索赔数据库共纳入 250 万名 20 岁或以上的糖尿病视网膜病变患者。分别构建了非增殖性DR/增殖性DR（NPDR/PDR）队列。参与者至少有一只眼睛失明。采用对数线性泊松年龄-时期-队列（APC）分析模型计算失明发生率，并估计每个研究组对失明的影响：结果：NPDR 组的失明率为 1326.62/100,000，PDR 组为 3397.57/100,000。2011 年后，失明率急剧下降，NPDR 组和 PDR 组每年分别下降 5.6% 和 4.4%。1920 年至 1930 年出生的人总体失明风险最高，此后风险迅速下降。在 1980 年以后出生的人中，男女失明风险都开始增加。在 APC 模型中，年龄、时期和队列效应的组合模型显示出最高的解释力（0.96）：在这项全国性的长期研究中，DR 失明并非由单一的流行病学原因造成，而是由生理年龄、社会决定因素和医疗保健政策共同作用的结果。二三十岁人群的失明风险在未来可能还会增加，这一点不容忽视。因此，建议对年轻患者保持警惕。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Eye 医学-眼科学

CiteScore

6.40

自引率

5.10%

发文量

481

审稿时长

3-6 weeks

期刊介绍： Eye seeks to provide the international practising ophthalmologist with high quality articles, of academic rigour, on the latest global clinical and laboratory based research. Its core aim is to advance the science and practice of ophthalmology with the latest clinical- and scientific-based research. Whilst principally aimed at the practising clinician, the journal contains material of interest to a wider readership including optometrists, orthoptists, other health care professionals and research workers in all aspects of the field of visual science worldwide. Eye is the official journal of The Royal College of Ophthalmologists. Eye encourages the submission of original articles covering all aspects of ophthalmology including: external eye disease; oculo-plastic surgery; orbital and lacrimal disease; ocular surface and corneal disorders; paediatric ophthalmology and strabismus; glaucoma; medical and surgical retina; neuro-ophthalmology; cataract and refractive surgery; ocular oncology; ophthalmic pathology; ophthalmic genetics.