Rates of progression in diabetic retinopathy during different time periods: A systematic review and meta-analysis

Tien Y. Wong, Mkaya Mwamburi, Ronald Klein, Michael Larsen, Harry W Flynn, Marisol Hernandez-Medina, Gayatri Ranganathan, Barbara Wirostko, Andreas Pleil, Paul Mitchell

Research output: Contribution to journalArticle

109 Citations (Scopus)

Abstract

OBJECTIVE- This meta-analysis reviews rates of progression of diabetic retinopathy to proliferative diabetic retinopathy (PDR) and/or severe visual loss (SVL) and temporal trends. RESEARCH DESIGN AND METHODS- This systematic literature review and metaanalysis of prospective studies assesses progression of retinopathy among diabetic patients without treatment for retinopathy at baseline. Studies published between 1975 to February 2008 were identified. Outcomes of interest were rates of progression to PDR and/or SVL. Pooled baseline characteristics and outcome measures were summarized using weighted averages of counts and means. Baseline characteristics and outcomes were compared between two periods: 1975-1985 and 1986-2008. RESULTS- A total of 28 studies comprising 27,120 diabetic patients (mean age 49.8 years) were included. After 4 years, pooled incidence rates for PDR and SVL were 11.0 and 7.2%, respectively. Rates were lower among participants in 1986-2008 than in 1975-1985. After 10 years, similar patterns were observed. Participants in 1986-2008 studies had lower proportions of PDR and non-PDR at all time points than participants in 1975-1985 studies. Conclusions - Since 1985, diabetic patients have lower rates of progression to pdr and SVL. These findings may reflect an increased awareness of retinopathy risk factors; earlier identification and initiation of care for patients with retinopathy; and improved medical management of glucose, blood pressure, and serum lipids. Differences in baseline characteristics, particularly in the prevalence and severity of retinopathy, could also have contributed to these temporal differences.

Original languageEnglish
Pages (from-to)2307-2313
Number of pages7
JournalDiabetes Care
Volume32
Issue number12
DOIs
StatePublished - Dec 1 2009

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Diabetic Retinopathy
Meta-Analysis
Patient Care
Research Design
Outcome Assessment (Health Care)
Prospective Studies
Blood Pressure
Lipids
Glucose
Incidence
Serum

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Advanced and Specialized Nursing

Cite this

Wong, T. Y., Mwamburi, M., Klein, R., Larsen, M., Flynn, H. W., Hernandez-Medina, M., ... Mitchell, P. (2009). Rates of progression in diabetic retinopathy during different time periods: A systematic review and meta-analysis. Diabetes Care, 32(12), 2307-2313. https://doi.org/10.2337/dc09-0615

Rates of progression in diabetic retinopathy during different time periods : A systematic review and meta-analysis. / Wong, Tien Y.; Mwamburi, Mkaya; Klein, Ronald; Larsen, Michael; Flynn, Harry W; Hernandez-Medina, Marisol; Ranganathan, Gayatri; Wirostko, Barbara; Pleil, Andreas; Mitchell, Paul.

In: Diabetes Care, Vol. 32, No. 12, 01.12.2009, p. 2307-2313.

Research output: Contribution to journalArticle

Wong, TY, Mwamburi, M, Klein, R, Larsen, M, Flynn, HW, Hernandez-Medina, M, Ranganathan, G, Wirostko, B, Pleil, A & Mitchell, P 2009, 'Rates of progression in diabetic retinopathy during different time periods: A systematic review and meta-analysis', Diabetes Care, vol. 32, no. 12, pp. 2307-2313. https://doi.org/10.2337/dc09-0615
Wong, Tien Y. ; Mwamburi, Mkaya ; Klein, Ronald ; Larsen, Michael ; Flynn, Harry W ; Hernandez-Medina, Marisol ; Ranganathan, Gayatri ; Wirostko, Barbara ; Pleil, Andreas ; Mitchell, Paul. / Rates of progression in diabetic retinopathy during different time periods : A systematic review and meta-analysis. In: Diabetes Care. 2009 ; Vol. 32, No. 12. pp. 2307-2313.
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