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. 2025 Oct;14(10):2599-2615.
doi: 10.1007/s40123-025-01230-y. Epub 2025 Aug 27.

Global, Regional, and National Burden of Blindness due to Diabetic Retinopathy, 1990-2021

Yang Meng #  1 , Yuan Liu #  1 , Yuan Ma #  1 , Ziye Chen  1 , Runping Duan  1 , Lan Jiang  1 , Tao Li  2
Affiliations

Global, Regional, and National Burden of Blindness due to Diabetic Retinopathy, 1990-2021

Yang Meng et al. Ophthalmol Ther. 2025 Oct.

Abstract

Introduction: This study aimed to analyze the patterns and trends in the burden of blindness due to diabetic retinopathy (DR) from 1990 to 2021 at the global, regional, and national levels.

Methods: We conducted a population-based analysis using the latest data from the Global Burden of Disease Study 2021. We examined the prevalence and number of cases of DR-related blindness stratified by type of diabetes, sex, age, and sociodemographic index (SDI) level. The trends in the blindness burden were quantified via the average annual percentage changes. A decomposition analysis was performed to identify key drivers of the changing burden. A Bayesian age‒period‒cohort model was used to predict the future burden of DR-related blindness from 2022 to 2035.

Results: Globally, the number of people blind due to DR increased by 326.0% from 1990 to 2021, with the age-standardized prevalence rate (ASPR) increasing from 7.59 to 15.28 per 100,000 population. Regionally, Tropical Latin America had the highest ASPR in 2021, whereas South Asia and East Asia had the greatest number of prevalent cases. Nationally, India and China had the highest number of prevalent cases in 2021, whereas Marshall Islands reported the highest ASPR. In 2021, the middle SDI group had the greatest number of patients who became blind due to DR. Decomposition analysis revealed that the increased global burden between 1990 and 2021 was driven by population growth, population aging, and epidemiological changes. Predictions suggest the burden will continue to rise through 2035.

Conclusions: The global burden of DR-related blindness has increased significantly over the past three decades, with notable disparities across regions, countries, and SDI groups. More efforts should be made to mitigate the growing impact of DR-related blindness.

Keywords: Blindness; Diabetes; Diabetic retinopathy; Epidemiology; GBD 2021.

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Conflict of interest statement

Declarations. Conflict of Interest: Yang Meng, Yuan Liu, Yuan Ma, Ziye Chen, Runping Duan, Lan Jiang, and Tao Li have nothing to disclose. Ethical Approval: The Institutional Review Board Committee of the University of Washington approved the GBD 2021 (approval number: STUDY00009060). Since this study used de-identified data from GBD 2021, no additional ethics approval was needed.

Figures

Fig. 1
Fig. 1
Global trends of blindness due to diabetic retinopathy, 1990–2021. AAPC average annual percentage change, APC annual percentage change, ASPR age-standardized prevalence rate, T1D type 1 diabetes, T2D type 2 diabetes. *Time segments in which the changes in trend were statistically significant
Fig. 2
Fig. 2
Regional burden of blindness due to diabetic retinopathy, 2021. ASPR age-standardized prevalence rate, T1D type 1 diabetes, T2D type 2 diabetes
Fig. 3
Fig. 3
Global map of blindness due to diabetic retinopathy, 2021. ASPR age-standardized prevalence rate, T1D type 1 diabetes, T2D type 2 diabetes
Fig. 4
Fig. 4
Sex-, age-, and SDI-based burden of blindness due to diabetic retinopathy, 2021. SDI sociodemographic index, T1D type 1 diabetes, T2D type 2 diabetes
Fig. 5
Fig. 5
SDI-based burden of blindness due to diabetic retinopathy, 1990–2021. ASPR age-standardized prevalence rate, SDI sociodemographic index, T1D type 1 diabetes, T2D type 2 diabetes
Fig. 6
Fig. 6
Decomposition analysis of blindness due to diabetic retinopathy, 1990–2021. SDI sociodemographic index, T1D type 1 diabetes, T2D type 2 diabetes
Fig. 7
Fig. 7
Predicted burden of blindness due to diabetic retinopathy, 2022–2035. ASPR age-standardized prevalence rate
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References

    1. Abel ED, Gloyn AL, Evans-Molina C, Joseph JJ, Misra S, Pajvani UB, et al. Diabetes mellitus-progress and opportunities in the evolving epidemic. Cell. 2024;187(15):3789–820. 10.1016/j.cell.2024.06.029. - PMC - PubMed
    1. Collaboration NCDRF. Worldwide trends in diabetes prevalence and treatment from 1990 to 2022: a pooled analysis of 1108 population-representative studies with 141 million participants. Lancet. 2024;404(10467):2077–93. 10.1016/S0140-6736(24)02317-1. - PMC - PubMed
    1. Yu MG, Gordin D, Fu J, Park K, Li Q, King GL. Protective factors and the pathogenesis of complications in diabetes. Endocr Rev. 2024;45(2):227–52. 10.1210/endrev/bnad030. - PMC - PubMed
    1. Hou X, Wang L, Zhu D, Guo L, Weng J, Zhang M, et al. Prevalence of diabetic retinopathy and vision-threatening diabetic retinopathy in adults with diabetes in China. Nat Commun. 2023;14(1):4296. 10.1038/s41467-023-39864-w. - PMC - PubMed
    1. Shan Y, Xu Y, Lin X, Lou L, Wang Y, Ye J. Burden of vision loss due to diabetic retinopathy in China from 1990 to 2017: findings from the global burden of disease study. Acta Ophthalmol. 2021;99(2):e267–73. 10.1111/aos.14573. - PubMed

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