Global and regional prevalence of diabetic retinopathy; a comprehensive systematic review and meta-analysis

Mohammadreza Asadollahi1 *, Reza Pakzad2 , Mehdi Khabazkhoob 3

  1. Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran, Iran
  2. Department of Epidemiology, Faculty of Health, Ilam University of Medical Sciences, Ilam
  3. Department of Medical Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Abstract: we conducted a systematic search to estimate DR prevalence in different age and gender groups, and to evaluate the determinants of heterogeneity in its prevalence

Methods: A systematic and comprehensive search from inception to August 10, 2020 was done in international databases, including Scopus, PubMed, Web of Science, Embase, and other data sources without any restriction to find cross sectional studies related to the prevalence of DR

Results: Of 5648 studies, 87 articles with a sample size of 541256 individuals and 212497 diabetic patients were analyzed. The estimated pooled prevalence of DR in the diabetic population in general; in female and in male was 28.41% (95% CI: 25.99 to 30.84); 26.10% (95% CI: 3.34 to 28.86) and 28.44% (95% CI: 25.56 to 31.32); respectively and the prevalence of DR showed no inter-gender difference. The heterogeneity of the pooled prevalence according to I2 was 99% (p<0.001). According to the meta-regression results, the variables of WHO region (b: 3.681; p<0.001), age (b: 8.01; p: 0.003), type of DR (b: 18.51; p<0.003), and publication year (b:-0.58; p: 0.001) had a significant correlation with heterogeneity

Conclusion: One third of diabetic patients suffer from DR, mostly NPDR. DR increased markedly after the age of 60 years, which could be due to the longer duration of diabetes. Age, WHO region, type of DR, and publication year affected the heterogeneity in the prevalence of DR. Our knowledge of the DR global prevalence can be helpful for effective screening and management of DR





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