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Meta-Analysis
. 2024 Aug;38(11):2047-2057.
doi: 10.1038/s41433-024-03101-5. Epub 2024 Jun 27.

Global estimates on the number of people blind or visually impaired by diabetic retinopathy: a meta-analysis from 2000 to 2020

Collaborators
Meta-Analysis

Global estimates on the number of people blind or visually impaired by diabetic retinopathy: a meta-analysis from 2000 to 2020

Vision Loss Expert Group of the Global Burden of Disease Study et al. Eye (Lond). 2024 Aug.

Abstract

Objectives: To estimate global and regional trends from 2000 to 2020 of the number of persons visually impaired by diabetic retinopathy and their proportion of the total number of vision-impaired individuals.

Methods: Data from population-based studies on eye diseases between 1980 to 2018 were compiled. Meta-regression models were performed to estimate the prevalence of blindness (presenting visual acuity <3/60) and moderate or severe vision impairment (MSVI; <6/18 to ≥3/60) attributed to DR. The estimates, with 95% uncertainty intervals [UIs], were stratified by age, sex, year, and region.

Results: In 2020, 1.07 million (95% UI: 0.76, 1.51) people were blind due to DR, with nearly 3.28 million (95% UI: 2.41, 4.34) experiencing MSVI. The GBD super-regions with the highest percentage of all DR-related blindness and MSVI were Latin America and the Caribbean (6.95% [95% UI: 5.08, 9.51]) and North Africa and the Middle East (2.12% [95% UI: 1.55, 2.79]), respectively. Between 2000 and 2020, changes in DR-related blindness and MSVI were greater among females than males, predominantly in the super-regions of South Asia (blindness) and Southeast Asia, East Asia, and Oceania (MSVI).

Conclusions: Given the rapid global rise in diabetes and increased life expectancy, DR is anticipated to persist as a significant public health challenge. The findings emphasise the need for gender-specific interventions and region-specific DR healthcare policies to mitigate disparities and prevent avoidable blindness. This study contributes to the expanding body of literature on the burden of DR, highlighting the need for increased global attention and investment in this research area.

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Conflict of interest statement

GBD 2019 Blindness and Vision Impairment Collaborators: T W Bärnighausen reports grants or contracts from the European Union (Horizon 2020 and EIT Health), German Research Foundation (DFG), US National Institutes of Health, German Ministry of Education and Research, Alexander von Humboldt Foundation, Else-Kröner-Fresenius-Foundation, Wellcome Trust, Bill & Melinda Gates Foundation, KfW, UNAIDS, and WHO; consulting fees from KfW on the OSCAR initiative in Vietnam; participation on a Data Safety Monitoring Board or Advisory Board with NIH-funded study “Healthy Options” (PIs: Smith Fawzi, Kaaya) as Chair of the Data Safety and Monitoring Board, German National Committee on the “Future of Public Health Research and Education” as Chair of the scientific advisory board to the EDCTP Evaluation, Member of the UNAIDS Evaluation Expert Advisory Committee, National Institutes of Health Study Section Member on Population and Public Health Approaches to HIV/AIDS (PPAH), US National Academies of Sciences, Engineering, and Medicine’s Committee for the “Evaluation of Human Resources for Health in the Republic of Rwanda under the President’s Emergency Plan for AIDS Relief (PEPFAR)”, University of Pennsylvania (UPenn) Population Aging Research Center (PARC) as an External Advisory Board Member; leadership or fiduciary roles in board, society, committee or advocacy groups, paid or unpaid with the Global Health Hub Germany (which was initiated by the German Ministry of Health) as co-chair; all outside the submitted work. R Bourne reports support for the present manuscript to their institution, supporting the Vision Loss Expert Group, from the World Health Organization, the Brien Holden Vision Institute, Foundation Thea, Fred Hollows Foundation, Lions Clubs International Foundation; Bourne reports grants or contracts outside the submitted work to their institution supporting the Vision Loss Expert Group from Sightsavers International and University of Heidelberg. X Dai reports support for the present manuscript from the Institute for Health Metrics and Evaluation (University of Washington) for their salary. D S Friedman reports grants or contracts to their institution for research from Genentech; consulting fees from Abbvie, Kaliyope, Life Biosciences, Bausch and Lomb; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Thea Pharmaceuticals; support for attending meetings and travels from Thea Pharmaceuticals; leadership or fiduciary roles in board, society, committee or advocacy groups, paid or unpaid with Orbis International as a Member of the Board of Governors; all outside the submitted work. J M Furtado reports consulting fees outside the submitted work from SightFirst Latin America and Pan American Health Organization. V B Gupta reports grants or contracts from National Health and Medical Research Council (NHMRC) provided to Deakin University; outside the submitted work. V K Gupta reports grants or contracts from National Health and Medical Research Council (NHMRC) provided to Macquarie University; outside the submitted work. S M S Islam reports support for the present manuscript from the National Health and Medical Research Council (NHMRC, Australia) via an investigator grant and from the Heart Foundation of Australia via a Vanguard Grant. J E Kim reports consulting fees from Allergan, Apellis, Astellas, Bausch&Lomb, Clearside Biomedical, DORC, Genentech/Roche, Notal Vision, Outlook Therapeutics, and Regeneron; leadership or fiduciary roles in board, society, committee or advocacy groups, unpaid, with American Society of Retina Specialists, Macula Society, American Academy of Ophthalmology, and NAEVR/AEVR; receipt of equipment for research from Optos; all outside the submitted work. K Krishan reports non-financial support from the UGC Centre of Advanced Study, CAS II, awarded to the Department of Anthropology, Panjab University (Chandigarh, India); outside the submitted work. J L Leasher reports leadership or fiduciary roles in board, society, committee or advocacy groups, unpaid as a member of the National Eye Institute National Eye Health Education Program planning committee; outside the submitted work. J D Steinmetz reports support for the present manuscript from the Bill and Melinda Gates Foundation IHME funding for GBD analyses. Y Tan reports support for the present manuscript from the Department of Ophthalmology, The Third Xiangya Hospital, Central South University and the Postdoctoral Station of Clinical Medicine, The Third Xiangya Hospital, Central South University. F Topouzis reports grants or contracts from Thea Pharma Inc., Omikron, Pfizer, Alcon, AbbVie, Bayer, paid to their institution; consulting fees paid to them from Thea Pharma Inc., Omikron, Bausch & Lomb; participation on a Data Safety Monitoring Board or Advisory Board with Omikron, paid to them, and AbbVie and Roche, paid to their institution; leadership or fiduciary roles in board, society, committee or advocacy groups, unpaid, with European Glaucoma Society as President, Greek Glaucoma Society as President, and World Glaucoma Association as member of the Board of Governors; all outside the submitted work. Vision Loss Expert Group of the Global Burden of Disease Study: A Bron reports payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Théa. M A Del Monte reports support for attending meetings and/or travel from the University of Michigan, and leadership or fiduciary roles in board, society, committee or advocacy groups, paid or unpaid as past president of Costenbader Society. D Friedman reports receipt of equipment, materials, drugs, medical writing, gifts or other services from LumenisCorp (instrumental loan). J M Furtado reports consulting fees from Pan American Health Organization and from Lions Club International Foundation. G Gazzard reports consulting fees from Alcon Laboratories, Inc; Allergan, Inc; BELKIN Vision LTD; Carl Zeiss Meditec; Elios; Genentech/Roche; Reichert; Théa and ViaLase; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Alcon Laboratories, Inc; BELKIN Vision Ltd; Carl Zeiss Meditec; Elios and Ellex; participation on a Data Safety Monitoring Board or Advisory Board with Alcon Laboratories, Inc; Allergan, Inc; BELKIN Vision Ltd; Carl Zeiss Meditec; Elios and Visufarma; and leadership or fiduciary role in other board, society, committee or advocacy group, paid or unpaid with Glaucoma UK Medical Advisory Board and UK&Eire Glaucoma Society as president. M E Hartnett reports support for the present manuscript (e.g., funding, provision of study materials, medical writing, article processing charges, etc.) from Michael F. Marmor, M.D. Professor of Retinal Science and Disease as endowment to support salary; grants or contracts from any entity (from National Eye Institute R01 EY017011 and National Eye Institute R01 EY015130) as partial salary support; patents planned, issued or pending (WO2015123561A2 and WO2021062169A1); and leadership or fiduciary role in other board, society, committee or advocacy group, paid or unpaid with Jack McGovern Coats’ Disease Foundation and as director of Women’s Eye Health and Macular Society Grant Review Chair. J H Kempen reports support for the present manuscript (e.g., funding, provision of study materials, medical writing, article processing charges, etc.) from Mass Eye and Ear Global Surgery Program (as support of salary); grants or contracts from any entity from Sight for Souls (as support of salary); and stock or stock options with Betaliq and Tarsier (both as small equity owner). J E Kim reports consulting fees from Genentech/Roche, DORC, Notal Vision and Outlook Therapeutics (all as payment to J E Kim); participation on a Data Safety Monitoring Board or Advisory Board with Allergan, Amgen, Apellis, Bausch&Lomb, Clearside, Coherus, Novartis and Regeneron (all as participation on advisory board); leadership or fiduciary role in other borad, society, committee or advocacy group, paid or unpaid, with AAO, APRIS, ASRS, Macular Society and NAEVR/AEVR (all unpaid); and receipt of equipment, materials, drugs, medical writing, gifts or other services from Clearside and Genentech/Roche (both for medical writing). V C Lansingh reports consulting fees from HelpMeSee (as an employee); and support for attending meetings and/or travel from HelpMeSee (pay airfare and hotel). J Leasher reports leadership or fiduciary role in other board, society, committee or advocacy group, paid or unpaid with National Eye Institute (as a member) and National Eye Health Education Program planning committee (unpaid). M Nowak reports participation on a Data Safety Monitoring Board or Advisory Board with Vision Express Co. Poland as the chairman of medical advisory board of Vision Express Co. Poland. T Peto reports grants or contracts from any entity from Novartis (paid to institution); payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Bayer, Novartis and Roche (paid to T Peto); and leadership or fiduciary role in other board, society, committee or advocacy group, paid or unpaid with European Association for Diabetic Eye Complications as current president (unpaid). P Ramulu reports grants or contracts from National Institute of Health and Perfuse Therapeutics; and consulting fees from Alcon and W. L. Gore. F Topouzis reports grants or contracts from Théa, Omikron, Pfizer, Alcon, Abbvie and Bayer (all paid to Institution); consulting fees from Omikron, Théa and Bausch & Lomb (all paid to Topouzis); payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Omikron (paid to Topouzis), Abbvie and Roche (both paid to Institute); and leadership or fiduciary role in other board, society, committee or advocacy group, paid or unpaid with European Glaucoma Society (as president), Greek Glaucoma Society (as president) and Board of Governors, World Glaucoma Association (all unpaid).

Figures

Fig. 1
Fig. 1. Prevalence of blindness and moderate to severe visual impairment (MSVI) due to diabetic retinopathy (DR) in 2020 across seven global burden of disease (GBD) super-regions.
Crude prevalence of blindness and MSVI due to DR in 2020 by age, across seven world GBD super-regions. a Crude prevalence of blindness due to DR in 2020 by seven world GBD super-regions by age. The graph demonstrates an increase in prevalence with age, with notable variations between super-regions. The super-regions are represented by different coloured lines. b Crude prevalence of MSVI in 2020 by seven world GBD super-regions by age. Similar to (a), the prevalence increases with age, highlighting disparities among different super-regions. Each super-region is depicted by a distinct coloured line.

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