Diabetic Retinopathy a "Major Public Health Problem"
in US
posted 04/22/04
8% of those with diabetes will develop blinding retinopathy
before age 40!
In the US, approximately 8% of diabetics develop potentially
blinding retinopathy before the age of 40, epidemiologists report in the
Archives of Ophthalmology. In a second report, researchers found that diabetic
retinopathy threatens the vision of nearly 30% of adults with type 1 diabetes
before 30 years of age.
The two research teams estimated the prevalence of diabetic retinopathy based on
pooled data from population-based eye surveys, the 1999 National Health
Interview Survey, and the 2000 US Census.
Dr. John H. Kempen, at Johns Hopkins University School of Medicine in Baltimore,
and members of the Eye Diseases Prevalence Research Group, evaluated eight
population-based studies in which the severity of diabetic retinopathy was
graded by a color fundus photograph reading center. They defined
vision-threatening disease as severe retinopathy, clinically significant macular
edema or both.
The crude prevalence of retinopathy was 40.3%, and the crude prevalence for
vision-threatening disease was 8.2%. In the general population, the
corresponding prevalence was 3.4% and 0.75%, respectively.
Because the prevalence of diabetes varies in different ethnic groups, there are
large differences in the prevalence of diabetic retinopathy, Dr. Kempen's group
reports. Compared with white persons, Hispanics are approximately 1.5 times as
likely and blacks are 1.3 times as likely to have diabetic retinopathy.
A second team of investigators, led by Dr. Monique S. Roy, at the University of
Medicine and Dentistry-New Jersey Medical School in Newark, used data from the
Wisconsin Epidemiologic Study of Diabetic Retinopathy and the New Jersey 725.
They found that 86.4% of type 1 diabetics between the ages of 18 to 30 have
diabetic retinopathy, which threatens vision in 42.1%. In the general
population, the corresponding prevalence was 0.37% and 0.18%, respectively.
Dr. Kempen's team points out that diabetic retinopathy often causes blindness
during working-age years, and is thus associated with large economic costs.
However, it is often preventable with intensive control of hyperglycemia and
hypertension, along with detection and treatment of patients with high-risk
diabetic retinopathy.
"Because diabetic retinopathy is a substantial public health problem, public and
private policy efforts directed toward improving primary and secondary
prevention programs are warranted," Dr. Roy's group writes.
"The key finding is that the burden of disease is large, and will become much
larger as the population gets more elderly."
Source: Diabetes In Control.com: Arch Ophthalmol
2004;122:546-563.
April
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