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Global and Regional Prevalence of Diabetic Retinopathy; a Comprehensive Systematic Review and Meta-Analysis of Cross Sectional Studies

46 Pages Posted: 4 Aug 2019

See all articles by Hassan Hashemi

Hassan Hashemi

Noor Eye Hospital - Noor Research Center for Ophthalmic Epidemiology

Reza Pakzad

Ilam University of Medical Sciences

Samira Heydarian

Mazandaran University of Medical Sciences

Mojgan Pakbin

Noor Eye Hospital - Noor Research Center for Ophthalmic Epidemiology

Abbasali Yekta

Mashhad University of Medical Sciences

Mohamadreza Aghamirsalim

Iran University of Medical Sciences

Hadi Ostadimoghaddam

Mashhad University of Medical Sciences

Mehdi Khabazkhoob

Shahid Beheshti University of Medical Sciences - Department of Medical Surgical Nursing; Noor Eye Hospital - Noor Research Center for Ophthalmic Epidemiology

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Abstract

Topic: Diabetic retinopathy (DR) prevalence was estimated by different studies but no study address to estimate the global prevalence of that. For this reason; we conducted a systematic search to estimate DR prevalence in different age and sex groups, and to evaluate the determinants of heterogeneity in its prevalence.

Clinical Relevance: Understanding global and regional DR prevalence is critical to planning of eye care services and prioritization of resource allocation to overcoming the burden of DR. Methods: A systematic and comprehensive search from inception to November 2, 2018 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. studies conducted in special groups like people presenting to hospitals or clinics has been excluded and the STROBE was used for quality assessment of the studies. The I2 index and random-effects model were applied to investigate heterogeneity and estimate the pooled prevalence; respectively.

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.

Funding Statement: Noor Research Center for Ophthalmic Epidemiology.

Declaration of Interests: No conflicting relationship exists for any author.

Ethical Approval Statement: Not required.

Keywords: Diabetic retinopathy; Global and regional prevalence; Systematic review; Meta analysis

Suggested Citation

Hashemi, Hassan and Pakzad, Reza and Heydarian, Samira and Pakbin, Mojgan and Yekta, Abbasali and Aghamirsalim, Mohamadreza and Ostadimoghaddam, Hadi and Khabazkhoob, Mehdi, Global and Regional Prevalence of Diabetic Retinopathy; a Comprehensive Systematic Review and Meta-Analysis of Cross Sectional Studies (July 31, 2019). Available at SSRN: https://ssrn.com/abstract=3429928

Hassan Hashemi

Noor Eye Hospital - Noor Research Center for Ophthalmic Epidemiology

Tehran
Iran

Reza Pakzad

Ilam University of Medical Sciences

Ilam
Iran

Samira Heydarian

Mazandaran University of Medical Sciences

Sari
Iran

Mojgan Pakbin

Noor Eye Hospital - Noor Research Center for Ophthalmic Epidemiology

Tehran
Iran

Abbasali Yekta

Mashhad University of Medical Sciences

Iran

Mohamadreza Aghamirsalim

Iran University of Medical Sciences

Hemmat Hwy
Tehran
Iran

Hadi Ostadimoghaddam

Mashhad University of Medical Sciences

Iran

Mehdi Khabazkhoob (Contact Author)

Shahid Beheshti University of Medical Sciences - Department of Medical Surgical Nursing ( email )

Iran

Noor Eye Hospital - Noor Research Center for Ophthalmic Epidemiology ( email )

Tehran
Iran

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