Diabetic Retinopathy: Who’s At Risk for Vision Loss?

In this systematic review, researchers assessed the incidence of sight-threatening diabetic retinopathy in type 2 diabetes (T2D) patients. The study authors, whose work was published in Diabetic Medicine, queried PubMed, Embase, Web of Science, and the COCHRANE Library for relevant articles published between January 2000 and January 2017. Studies eligible for inclusion in the review included > 100 T2D patients who did not have moderate or more severe diabetic retinopathy at their last screening session and had at least two gradable retinal screening sessions. Primary outcome measures included moderate and severe non-proliferative diabetic retinopathy (R2), proliferative diabetic retinopathy (R3), or maculopathy (M1)—or “sight-threatening or referable diabetic retinopathy.” Seventeen studies were included. In T2D patients without baseline mild diabetic retinopathy, the average incidence rate of sight-threatening diabetic retinopathy was about 1 per 100 person-years, compared to about 8 per 100 person-years in patients with baseline diabetic retinopathy. In patients with and without mild diabetic retinopathy at their last screening, it took an average 175 people versus 19 people, respectively, to detect one case of sight-threatening diabetic retinopathy. The authors concluded that patients who do not have mild diabetic retinopathy may not require screening as frequently as patients who do have it.