Global Prevalence of Diabetic Retinopathy and Projection of Burden through 2045

IF 10.9 1区医学 Q1 OPHTHALMOLOGY

Ophthalmology Pub Date : 2021-11-01 Epub Date: 2021-05-01 DOI:10.1016/j.ophtha.2021.04.027

Zhen Ling Teo MBBS, MRCS (Edin) , Yih-Chung Tham PhD , Marco Yu PhD , Miao Li Chee BSc , Tyler Hyungtaek Rim MD, PhD , Ning Cheung MD , Mukharram M. Bikbov MD, PhD , Ya Xing Wang MD , Yating Tang MD, PhD , Yi Lu MD, PhD , Ian Y. Wong MD, FRCOphth , Daniel Shu Wei Ting MD, PhD , Gavin Siew Wei Tan MD, PhD , Jost B. Jonas MD , Charumathi Sabanayagam MD, PhD , Tien Yin Wong MD, PhD , Ching-Yu Cheng MD, PhD

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引用次数: 513

Abstract

Topic

To provide updated estimates on the global prevalence and number of people with diabetic retinopathy (DR) through 2045.

Clinical Relevance

The International Diabetes Federation (IDF) estimated the global population with diabetes mellitus (DM) to be 463 million in 2019 and 700 million in 2045. Diabetic retinopathy remains a common complication of DM and a leading cause of preventable blindness in the adult working population.

Methods

We conducted a systematic review using PubMed, Medline, Web of Science, and Scopus for population-based studies published up to March 2020. Random effect meta-analysis with logit transformation was performed to estimate global and regional prevalence of DR, vision-threatening DR (VTDR), and clinically significant macular edema (CSME). Projections of DR, VTDR, and CSME burden were based on population data from the IDF Atlas 2019.

Results

We included 59 population-based studies. Among individuals with diabetes, global prevalence was 22.27% (95% confidence interval [CI], 19.73%–25.03%) for DR, 6.17% (95% CI, 5.43%–6.98%) for VTDR, and 4.07% (95% CI, 3.42%–4.82%) for CSME. In 2020, the number of adults worldwide with DR, VTDR, and CSME was estimated to be 103.12 million, 28.54 million, and 18.83 million, respectively; by 2045, the numbers are projected to increase to 160.50 million, 44.82 million, and 28.61 million, respectively. Diabetic retinopathy prevalence was highest in Africa (35.90%) and North American and the Caribbean (33.30%) and was lowest in South and Central America (13.37%). In meta-regression models adjusting for habitation type, response rate, study year, and DR diagnostic method, Hispanics (odds ratio [OR], 2.92; 95% CI, 1.22–6.98) and Middle Easterners (OR, 2.44; 95% CI, 1.51–3.94) with diabetes were more likely to have DR compared with Asians.

Discussion

The global DR burden is expected to remain high through 2045, disproportionately affecting countries in the Middle East and North Africa and the Western Pacific. These updated estimates may guide DR screening, treatment, and public health care strategies.

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2045年糖尿病视网膜病变的全球患病率和负担预测

主题提供截至2045年全球糖尿病视网膜病变（DR）患病率和人数的最新估计。临床进展国际糖尿病联合会（IDF）估计，2019年全球糖尿病（DM）人口为4.63亿，2045年为7亿。糖尿病视网膜病变仍然是糖尿病的常见并发症，也是成年工作人群中可预防失明的主要原因。方法我们使用PubMed、Medline、Web of Science和Scopus对截至2020年3月发表的基于人群的研究进行了系统综述。采用logit变换进行随机效应荟萃分析，以评估DR、威胁视力的DR（VTDR）和临床显著黄斑水肿（CSME）的全球和地区患病率。DR、VTDR和CSME负荷的预测基于IDF Atlas 2019的人群数据。结果我们纳入了59项基于人群的研究。在糖尿病患者中，DR的全球患病率为22.27%（95%置信区间[CI]，19.73%-25.03%），VTDR的全球发病率为6.17%（95%可信区间，5.43%-6.98%），CSME的全球患病度为4.07%（95%CI，3.42%-4.82%）。2020年，全球患有DR、VTDR和CSME的成年人人数估计分别为1.0312亿、2854万和1883万；到2045年，这一数字预计将分别增至16050万、4482万和2861万。糖尿病视网膜病变的患病率在非洲（35.90%）、北美和加勒比地区（33.30%）最高，在南美洲和中美洲最低（13.37%）。在调整居住类型、有效率、研究年份和DR诊断方法的元回归模型中，与亚洲人相比，患有糖尿病的西班牙裔（OR，2.92；95%CI，1.22-6.98）和中东人（OR，2.44，95%CI，1.51-3.94）患DR的可能性更大。这些更新的估计可能指导DR筛查、治疗和公共卫生保健策略。

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

Ophthalmology 医学-眼科学

CiteScore

22.30

自引率

3.60%

发文量

412

审稿时长

18 days

期刊介绍： The journal Ophthalmology, from the American Academy of Ophthalmology, contributes to society by publishing research in clinical and basic science related to vision.It upholds excellence through unbiased peer-review, fostering innovation, promoting discovery, and encouraging lifelong learning.