What is the epidemiology of diabetic retinopathy?

Updated: Sep 02, 2021
  • Author: Abdhish R Bhavsar, MD; Chief Editor: Romesh Khardori, MD, PhD, FACP  more...
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Of the approximately 16 million Americans with diabetes, 50% are unaware that they have it. Of those who know they have diabetes, only half receive appropriate eye care. Thus, it is not surprising that diabetic retinopathy is the leading cause of new blindness in persons aged 25-74 years in the United States.

Approximately 700,000 Americans have proliferative diabetic retinopathy, with an annual incidence of 65,000. Approximately 500,000 persons have clinically significant macular edema, with an annual incidence of 75,000.

Diabetes is responsible for approximately 8000 eyes becoming blinded each year, meaning that diabetes is responsible for 12% of blindness. [23] The rate is even higher among certain ethnic groups. An increased risk of diabetic retinopathy appears to exist in patients of Native American, Hispanic, and African American heritage.

With increasing duration of diabetes or with increasing age since its onset, there is a higher risk of developing diabetic retinopathy and its complications, including diabetic macular edema or proliferative diabetic retinopathy.

Nonetheless, a literature review by Sabanayagam et al indicated that although the prevalence of diabetes has increased worldwide, the incidence of diabetic retinopathy–related blindness has fallen, especially in developed nations. [26]

A retrospective study by Porter et al of patients under age 21 years with type 1 or type 2 diabetes mellitus seen at an urban tertiary eye-care center found the overall incidence of diabetic retinopathy in these individuals to be 3.8%. More specifically, the rates were 3.4% and 6% in patients with type 1 and type 2 diabetes, respectively. Moreover, diabetic retinopathy occurred after a shorter disease duration in patients with type 2 diabetes than in those with type 1. The investigators also found no diabetic retinopathy in patients with an HbA1c level below 8%. [27]

For more information, see Macular Edema.

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