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Epidemiology Of Diabetic Retinopathy, Diabetic Macular Edema And Related Vision Loss

Epidemiology Of Diabetic Retinopathy, Diabetic Macular Edema And Related Vision Loss

Epidemiology Of Diabetic Retinopathy, Diabetic Macular Edema And Related Vision Loss

Epidemiology of diabetic retinopathy, diabetic macular edema and related vision loss Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Graduate Medical School, Singapore, Singapore Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Graduate Medical School, Singapore, Singapore Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Graduate Medical School, Singapore, Singapore Charumathi Sabanayagam, Phone: +65 6576 7286, Email: [email protected] . Received 2015 Aug 11; Accepted 2015 Sep 1. Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( ), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( ) applies to the data made available in this article, unless otherwise stated. This article has been cited by other arti Continue reading >>

The Impact Of Diabetic Retinopathy And Diabetic Macular Edema On Health-related Quality Of Life In Type 1 And Type 2 Diabetes | Iovs | Arvo Journals

The Impact Of Diabetic Retinopathy And Diabetic Macular Edema On Health-related Quality Of Life In Type 1 And Type 2 Diabetes | Iovs | Arvo Journals

Clinical and Epidemiologic Research| February 2012 The Impact of Diabetic Retinopathy and Diabetic Macular Edema on Health-Related Quality of Life in Type 1 and Type 2 Diabetes From the Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, Melbourne, Australia; From the Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, Melbourne, Australia; Centre for Clinical Change and Health and Health Care Research, Flinders University, Adelaide, Australia; National Health and Medical Research Council Centre for Clinical Eye Research, Discipline of Optometry and Vision Science, Flinders University and Flinders Medical Centre, Adelaide, Australia; and From the Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, Melbourne, Australia; From the Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, Melbourne, Australia; Singapore Eye Research Institute, Singapore National Eye Centre, Singapore. From the Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, Melbourne, Australia; Singapore Eye Research Institute, Singapore National Eye Centre, Singapore. Corresponding author: Ecosse L. Lamoureux, Department of Ophthalmology, University of Melbourne, 32 Gisborne Street, East Melbourne, Victoria, Australia, 3002; [email protected] . Investigative Ophthalmology & Visual Science February 2012, Vol.53, 677-684. doi:10.1167/iovs.11-8992 The Impact of Diabetic Retinopathy and Diabetic Macular Edema on Health-Related Quality of Life in Type 1 and Type 2 Diabetes You will receive an email whenever this article is corrected, updated, or cited in the literature. You can man Continue reading >>

Diabetic Retinopathy And Diabetic Macular Edema

Diabetic Retinopathy And Diabetic Macular Edema

Diabetic Retinopathy and Diabetic Macular Edema Department of Ophthalmology and Visual Sciences Nguyen QD, Rodrigues EB, Farah ME, Mieler WF, Do DV (eds): Retinal Pharmacotherapeutics. Dev Ophthalmol. Basel, Karger, 2016, vol 55, pp 137-146 Diabetic retinopathy and diabetic macular edema result from chronic damage to the neurovascular structures of the retina. The pathophysiology of retinal damage remains uncertain but includes metabolic and neuroinflammatory insults. These mechanisms are addressed by intensive metabolic control of the systemic disease and by the use of ocular anti-inflammatory agents, including vascular endothelial growth factor inhibitors and corticosteroids. Improved understanding of the ocular and systemic mechanisms that underlie diabetic retinopathy will lead to improved means to diagnose and treat retinopathy and better maintain vision. This chapter summarizes the pathogenesis, risk factors, diagnosis, signs and symptoms, and treatment options for diabetic retinopathy (DR) and diabetic macular edema (DME). The complex nature of DR has led to a variety of therapies, but treatments for DR and DME are still challenging, particularly in the stages when retinopathy is mild and patients retain good vision. DR is one of the major complications of diabetes and is a leading cause of blindness and vision impairment. Approximately 75% of persons suffering from type 1 diabetes develop retinopathy, while approximately 50% of persons with type 2 diabetes may develop retinopathy [ 1 ], and approximately 25% of persons with diabetes may develop macular edema. During the next two decades, over 360 million people worldwide are projected to have diabetes and its complications [ 2 ]. Fortunately, the prevalence of severe retinopathy and nephropathy in patients with Continue reading >>

Epidemiology Of Diabetic Retinopathy

Epidemiology Of Diabetic Retinopathy

Acute and chronic complications of diabetes Diabetic retinopathy (DR) is the leading cause of visual loss and blindness in working age populations in the developed world. Although everyone with a diagnosis of diabetes is at risk of developing retinopathy, only a minority progress to sight-threatening complications. These are for the most part preventable. Since the prevalence of diabetes is rising rapidly, particularly in Asian countries, and people are living longer following diagnosis, diabetic retinopathy has emerged as a major public health concern. Despite this, accurate data on its prevalence and outcome worldwide are still lacking. Almost all patients with diabetes show evidence of retinal changes over the course of time, if investigated with sufficiently sensitive techniques, and that a large minority - up to half in some populations - progress to sight-threatening variants of the condition. This proportion has fallen over time, most likely because of improved glucose control, and techniques of ophthalmic management have improved in parallel. Epidemiology has played an essential role in monitoring the impact of diabetic retinopathy at a population level, and the success or failure of public health measures designed to influence the course of this largely preventable condition. Worldwide Prevalence of Diabetic Retinopathy A recent pooled analysis from 35 population-based studies estimated that 93 million people worldwide have diabetic retinopathy, of whom 17 million (~18%) have proliferative DR, 21 million (~23%) have diabetic macular edema (DME), and 28 million (~20%) have sight-threatening DR [1] . Among people with diabetes, this translates to an overall prevalence of 34.6% for any DR, 7.0% for proliferative DR, 6.8% for DME, and 10.2% for sight-threatening D Continue reading >>

Prevalence, Demographics, And Treatment Characteristics Of Visual Impairment Due To Diabetic Macular Edema In A Representative Canadian Cohort

Prevalence, Demographics, And Treatment Characteristics Of Visual Impairment Due To Diabetic Macular Edema In A Representative Canadian Cohort

Prevalence, Demographics, and Treatment Characteristics of Visual Impairment due to Diabetic Macular Edema in a Representative Canadian Cohort 1Aging, Rehabilitation and Geriatric Care Program, Lawson Health Research Institute, London, ON, Canada N6C 2R5 2Individual Health Outcomes Inc., ON, Canada N5X 3W7 3Parkwood Hospital, Aging, Rehabilitation and Geriatric Care Research Center, B-3002, 801 Commissioners Rd E., London, ON, Canada N6C 5J1 4Outcomes Research, Novartis Pharmaceuticals Canada Inc., Dorval, QC, Canada H9S 1A9 Received 20 June 2012; Revised 10 November 2012; Accepted 11 November 2012 Copyright 2012 Robert J. Petrella et al. This is an open access article distributed under the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Diabetic macular edema (DME) is the leading cause of blindness in the diabetic population. However, there is limited understanding of the epidemiology of DME with visual impairment (VI) and treatment in patients with diabetes in Canada. This observational, retrospective study used records from the Southwestern Ontario database to observe the demographics, prevalence, and treatment characteristics of VI due to DME compared to a healthy population in a real-world Canadian setting. Data was compared between a cohort of 8,368 diabetic (type 1 or 2) patients, who were 18 years old and had a diagnosis of DME with VI (visual acuity <20/40 in Snellen equivalent), and 76,077 age- and gender-matched subjects representing a healthy population. Among diabetic patients, prevalence of DME was 15.7%, and prevalence of VI due to DME was 2.56%. Laser monotherapy was the most frequently used treatment. Public funding covered costs for 85% o Continue reading >>

Epidemiology Of Diabetic Retinopathy, Diabetic Macular Edema And Related Vision Loss

Epidemiology Of Diabetic Retinopathy, Diabetic Macular Edema And Related Vision Loss

Diabetic retinopathy (DR) is a leading cause of vision-loss globally. Of an estimated 285 million people with diabetes mellitus worldwide, approximately one third have signs of DR and of these, a further one third of DR is vision-threatening DR, including diabetic macular edema (DME). The identification of established modifiable risk factors for DR such as hyperglycemia and hypertension has provided the basis for risk factor control in preventing onset and progression of DR. Additional research investigating novel risk factors has improved our understanding of multiple biological pathways involved in the pathogenesis of DR and DME, especially those involved in inflammation and oxidative stress. Variations in DR prevalence between populations have also sparked interest in genetic studies to identify loci associated with disease susceptibility. In this review, major trends in the prevalence, incidence, progression and regression of DR and DME are explored, and gaps in literature identified. Established and novel risk factors are also extensively reviewed with a focus on landmark studies and updates from the recent Keywords: Diabetic retinopathy, Diabetic macular edema, Epidemiology, Risk factors Diabetic Retinopathy (DR) is the leading cause of vision loss in adults aged 2074 years [1]. From 19902010, DR ranked as the fifth most common cause of preventable blindness and fifth most common cause of moderate to severe visual impairment [2]. In 2010, of an estimated 285 million people worldwide with diabetes, over one-third have signs of DR, and a third of these are afflicted with vision-threatening diabetic retinopathy (VTDR), defined as severe non-proliferative DR or proliferative DR (PDR) or the presence of diabetic macular edema (DME) [3]. These estimates are expected to Continue reading >>

Diabetic Retinopathy: Global Prevalence, Major Risk Factors, Screening Practices And Public Health Challenges: A Review

Diabetic Retinopathy: Global Prevalence, Major Risk Factors, Screening Practices And Public Health Challenges: A Review

Clinical & Experimental Ophthalmology Singapore National Eye Center, Singapore Health Service (SingHealth), Singapore, Singapore Singapore Eye Research Institute, Singapore, Singapore Singapore National Eye Center, Singapore Health Service (SingHealth), Singapore, Singapore Singapore Eye Research Institute, Singapore, Singapore DukeNUS Graduate Medical School, Singapore, Singapore Singapore National Eye Center, Singapore Health Service (SingHealth), Singapore, Singapore Singapore Eye Research Institute, Singapore, Singapore DukeNUS Graduate Medical School, Singapore, Singapore Correspondence: Prof Tien Yin Wong, Singapore National Eye Center, 11 Third Hospital Avenue, Singapore 168751, Singapore. Email: [email protected] Search for more papers by this author Singapore National Eye Center, Singapore Health Service (SingHealth), Singapore, Singapore Singapore Eye Research Institute, Singapore, Singapore Singapore National Eye Center, Singapore Health Service (SingHealth), Singapore, Singapore Singapore Eye Research Institute, Singapore, Singapore DukeNUS Graduate Medical School, Singapore, Singapore Singapore National Eye Center, Singapore Health Service (SingHealth), Singapore, Singapore Singapore Eye Research Institute, Singapore, Singapore DukeNUS Graduate Medical School, Singapore, Singapore Correspondence: Prof Tien Yin Wong, Singapore National Eye Center, 11 Third Hospital Avenue, Singapore 168751, Singapore. Email: [email protected] Search for more papers by this author Please review our Terms and Conditions of Use and check box below to share full-text version of article. I have read and accept the Wiley Online Library Terms and Conditions of Use. Use the link below to share a full-text version of this article with your friends and colleagues. Continue reading >>

Diabetic Retinopathy And Diabetic Macular Edema

Diabetic Retinopathy And Diabetic Macular Edema

Diabetic retinopathy (DR) and diabetic macular edema (DME) are leading causes of blindness in the working-age population of most developed countries. The increasing number of individuals with diabetes worldwide suggests that DR and DME will continue to be major contributors to vision loss and associated functional impairment for years to come. Early detection of retinopathy in individuals with diabetes is critical in preventing visual loss, but current methods of screening fail to identify a sizable number of high-risk patients. The control of diabetes-associated metabolic abnormalities (i.e., hyperglycemia, hyperlipidemia, and hypertension) is also important in preserving visual function because these conditions have been identified as risk factors for both the development and progression of DR/DME. The currently available interventions for DR/DME, laser photocoagulation and vitrectomy, only target advanced stages of disease. Several biochemical mechanisms, including protein kinase C–β activation, increased vascular endothelial growth factor production, oxidative stress, and accumulation of intracellular sorbitol and advanced glycosylation end products, may contribute to the vascular disruptions that characterize DR/DME. The inhibition of these pathways holds the promise of intervention for DR at earlier non–sight-threatening stages. To implement new therapies effectively, more individuals will need to be screened for DR/DME at earlier stages—a process requiring both improved technology and interdisciplinary cooperation among physicians caring for patients with diabetes. CURRENT EPIDEMIOLOGY, NEW PATHOPHYSIOLOGY INSIGHTS, UPDATED DIAGNOSTIC STAGING SYSTEM, RECENT SCREENING TECHNOLOGIES, AND TREATMENT Diabetic retinopathy (DR) and diabetic macular edema (DME) are Continue reading >>

Differences In Incidence Of Diabetic Retinopathy Between Type 1 And 2 Diabetes Mellitus: A Nine-year Follow-up Study

Differences In Incidence Of Diabetic Retinopathy Between Type 1 And 2 Diabetes Mellitus: A Nine-year Follow-up Study

It is estimated that more than 200 million people worldwide currently have diabetes and that number is predicted to rise by over 120% by 2025.1 It has become a chronic disease with several complications. Diabetes mellitus (DM) is classified as type 1 diabetes (T1DM) or type 2 diabetes (T2DM), gestational diabetes, monogenic diabetes and secondary diabetes.2 There is a current trend towards more children developing T1DM and more than half a million children are estimated to be living with the disease. The most important ocular complication is diabetic retinopathy (DR), a common cause of blindness in Europe.3 Development of DR is similar in both DM types. DR screening uses a non-mydriatic fundus camera, a cost-effective way of screening DM populations.4 Screening frequency varies according to DM type.5 Our group rolled out a screening programme in 2000 that included general practitioners and endocrinologists,6 and we reported an increase in the incidence of DR in a previously published study.7 In this study, we determine the incidence of any-DR, sight-threatening retinopathy (STDR) and diabetic macular oedema (DMO) in patients with T1DM and its differences in patients with T2DM. Materials and methods Setting: The reference population in our area is 247 174. The total number of patients with DM registered with our healthcare area is 17 792 (7.1%). Design: A prospective, population-based study, conducted from 1 January 2007 to 31 December 2015. A total of 366 patients with T1DM and 15 030 with T2DM were screened. Power of the study: Our epidemiologist estimates the detection of a ±3% increase in risk and 95% accuracy. Method: Screening for DR was carried out with one 45° field retinography, centred on the fovea. If DR was suspected, a total of nine retinographies of 45° Continue reading >>

Diabetic Retinopathy

Diabetic Retinopathy

Diabetic retinopathy, also known as diabetic eye disease, is a medical condition in which damage occurs to the retina due to diabetes and is a leading cause of blindness.[1] It affects up to 80 percent of people who have had diabetes for 20 years or more.[2] At least 90% of new cases could be reduced if there were proper treatment and monitoring of the eyes.[3] The longer a person has diabetes, the higher his or her chances of developing diabetic retinopathy.[4] Each year in the United States, diabetic retinopathy accounts for 12% of all new cases of blindness. It is also the leading cause of blindness for people aged 20 to 64 years.[5] Signs and symptoms[edit] Normal vision The same view with diabetic retinopathy. Emptied retinal venules due to arterial branch occlusion in diabetic retinopathy (fluorescein angiography) Diabetic retinopathy often has no early warning signs. Even macular edema, which can cause rapid vision loss, may not have any warning signs for some time. In general, however, a person with macular edema is likely to have blurred vision, making it hard to do things like read or drive. In some cases, the vision will get better or worse during the day. In the first stage which is called non-proliferative diabetic retinopathy (NPDR) there are no symptoms, the signs are not visible to the eye and patients will have 20/20 vision. The only way to detect NPDR is by fundus photography, in which microaneurysms (microscopic blood-filled bulges in the artery walls) can be seen. If there is reduced vision, fluorescein angiography can be done to see the back of the eye. Narrowing or blocked retinal blood vessels can be seen clearly and this is called retinal ischemia (lack of blood flow). Macular edema in which blood vessels leak their contents into the macular regi Continue reading >>

Genentech: Retinal Diseases Fact Sheet

Genentech: Retinal Diseases Fact Sheet

Wet Age-Related Macular Degeneration (Wet AMD) Approximately 90 percent of all AMD-related severe vision loss results from wet AMD1 11 million Americans have some form of AMD, while 1.1 million, or 10 percent, of those Americans have wet AMD1, 2 About 200,000 new cases of wet AMD are diagnosed each year in the United States3 Risk for wet AMD increases for people over age 604 Women tend to be at greater risk than men, and Caucasians are more likely to develop AMD than other races5 Similarly, smoking, obesity and family history could also increase a persons risk of developing wet AMD5 Difficulty seeing at a distance or doing detailed work1 Blind spots develop in the middle of the field of vision6 Diabetic retinopathy impacts nearly 7.7 million Americans. The number is expected to increase to 11.3 million by 20307 Between 40 and 45 percent of Americans diagnosed with diabetes have some stage of diabetic retinopathy8 Diabetic retinopathy can lead to conditions that threaten vision loss, including diabetic macular edema (DME) and advanced disease, both of which may lead to vision loss8 All people with type 1 and type 2 diabetes are at risk8 The longer a person has diabetes, especially if it is poorly controlled, the higher the risk for developing diabetic retinopathy8 People with a history of high blood pressure and atherosclerosis are at an increased risk for developing diabetic retinopathy9 In its early stages, diabetic retinopathy is often without noticeable symptoms8 As the disease progresses, symptoms may include blurred vision and loss of contrast10 Symptoms may also include patches of vision loss, which may appear as small black dots or lines "floating" across the front of the eye10 DME is a type of DR that is a leading cause of vision loss for people with diabetes11 Continue reading >>

Prevalence Of And Risk Factors For Diabetic Macular Edema In The United States

Prevalence Of And Risk Factors For Diabetic Macular Edema In The United States

Prevalence of Diabetic Macular Edema (DME) Stratified by Race/Ethnicity in the US Population Aged 40 Years or Older in the National Health and Nutrition Examination Survey (NHANES) Error bars represent 95% CIs. Hispanics included both Mexican American and nonMexican American Hispanics. Estimated Prevalence of Diabetic Macular Edema (DME) by Glycosylated Hemoglobin A1c (HbA1c) Levels, Stratified by Diabetes Duration for All Persons With Diabetes Mellitus in the National Health and Nutrition Examination Survey (NHANES) The glycemia-specific prevalence data for all persons by each 0.5% difference were plotted to show the independent relationship of glycemia with prevalence of DME. Margin plots were obtained with a logistic regression model that included HbA1c and the quadratic and cubic terms for HbA1c (P < .01) and adjusted for all other covariates. Probabilities of DME prevalence were estimated using individual HbA1c values for each subject along with the means of all other covariates. Shading represents 95% CIs for the predicted probabilities. Prevalence Estimates Among US Adults With Diabetes Aged 40 Years or Oldera Baseline and Clinical Characteristics of Persons With or Without DME in the US Population Aged 40 Years or Older With Diabetesa Continue reading >>

Phase Iia Study In Diabetic Retinopathy | Press

Phase Iia Study In Diabetic Retinopathy | Press

Boehringer Ingelheim is initiating Phase IIa study for the development of a new treatment for diabetic retinopathy a leading cause of vision-loss Diabetic retinopathy (DR) is the second severe metabolic complication on top of non-alcoholic steatohepatitis (NASH) to be investigated for BI 1467335, which was acquired from Pharmaxis Pharmaxis will receive 10 million milestone payment when the first patient is dosed in this 2nd indication Phase IIa study. Boehringer Ingelheims holistic cardio metabolism R&D strategy reaches from risk factors, like obesity to complications, like NASH and DR INGELHEIM, Germany and SYDNEY, Australia 7 September 2017 Boehringer Ingelheim and pharmaceutical research company Pharmaxis (ASX: PXS) announce that Boehringer Ingelheim is initiating the Phase IIa study ROBIN (Randomized study of Orally administered BI 1467335 in patients with Non-proliferative diabetic retinopathy without center-involved diabetic macular edema). This marks the beginning of the clinical development program for BI 1467335 in a second indication targeting a severe diabetes complication. An already ongoing Phase II clinical study program is investigating the compound in NASH. BI 1467335 is an oral inhibitor of amine oxidase, copper containing 3 (AOC3)1. Diabetic retinopathy (DR) is the leading cause of vision-loss in adults aged 20-74. It progresses from mild nonproliferative diabetic retinopathy to moderate and severe nonproliferative diabetic retinopathy (NPDR), characterized by retinal hemorrhages and vascular changes in the retina, to proliferative diabetic retinopathy (PDR), characterized by the growth of new blood vessels on the retina. Diabetic Macular Edema (DME), characterized by retinal thickening from leaky blood vessels, can develop at all stages of retinopath Continue reading >>

Overview Of Diabetic Macular Edema

Overview Of Diabetic Macular Edema

Supplements > Improving Outcomes in Diabetic Macular Edema: The Impact of New Therapies in Managed Care Published on: July 26, 2016 Almost 20 years ago, the Melbourne Vision Impairment Project found that almost 60% of those with DM did not undergo an eye exam in the previous year53; those numbers have improved slightly, but remain far from the recommended 100%. According to the AAO, upwards of 40% of individuals with DM forego annual screenings for DR.10 The ADA recommends initial screening within 5 years of diagnosis if T1DM is confirmed, and annually for both T1DM and T2DM.34 Patients are often unaware of how DM will affect their vision. A Joslin Vision Network study (N = 2795) found that 83% of patients with DR and 78% with vision-threatening DR were unaware that they had the disease at their first visit, and 50% with vision-threatening DR had longer than recommended intervals for follow-up eye exams.54 For patients with T2DM, signs of ocular complications are often present at the time of diagnosis of DM.54,55 Yet, as recent as 2010, less than 45% of US adults with DME reported that a physician explained that the disease had affected their eye or that they had retinopathy.55Numerous studies have correlated quality of life with improved vision. In one study of cost-effectiveness of treatment in patients with DME, combination therapy (laser treatment and an anti-VEGF treatment) achieved the largest quality-adjusted life-years, followed by monotherapy with an anti-VEGF agent.56 A recent cross-sectional study assessing the impact of DR on quality of life and treatment satisfaction used the Audit of Diabetes-Dependent Quality of Life questionnaire and the Diabetes Treatment Satisfaction Questionnaire.57 DR severity had a substantial influence on perceived quality of life Continue reading >>

Epidemiology Of Diabetic Retinopathy, Diabetic Macular Edema And Related Vision Loss.

Epidemiology Of Diabetic Retinopathy, Diabetic Macular Edema And Related Vision Loss.

Epidemiology of diabetic retinopathy, diabetic macular edema and related vision loss. Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore ; Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore. Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore ; Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore ; Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Graduate Medical School, Singapore, Singapore. Eye Vis (Lond). 2015 Sep 30;2:17. doi: 10.1186/s40662-015-0026-2. eCollection 2015. Diabetic retinopathy (DR) is a leading cause of vision-loss globally. Of an estimated 285 million people with diabetes mellitus worldwide, approximately one third have signs of DR and of these, a further one third of DR is vision-threatening DR, including diabetic macular edema (DME). The identification of established modifiable risk factors for DR such as hyperglycemia and hypertension has provided the basis for risk factor control in preventing onset and progression of DR. Additional research investigating novel risk factors has improved our understanding of multiple biological pathways involved in the pathogenesis of DR and DME, especially those involved in inflammation and oxidative stress. Variations in DR prevalence between populations have also sparked interest in genetic studies to identify loci associated with disease susceptibility. In this review, major trends in the prevalence, incidence, progression and regression of DR and DME are explored, and gaps in literature identified. Established and novel risk factors are also extensively reviewed with a focus on landmark studies and updates from the recent literature. Continue reading >>

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