DENVER — Prevalence of diabetic retinal disease (DRD) declined modestly over a 20-year period, while severe forms dropped substantially, a large retrospective cohort study showed.

Overall, the hazard ratio for progression to DRD decreased 20% from 2002 to 2022, but most of the decline occurred during the first 10 years. Thereafter, more at-risk patients with diabetes progressed to DRD.

Better diabetes medications, better screening, older age at onset of DRD influence 20-year trend

However, progression to more severe, vision-threatening forms of DRD showed a different epidemiologic picture, as the hazard for vision-threatening diabetic retinopathy (VTDR) decreased by 55%, diabetic macular edema (DME) by 47%, and proliferative diabetic retinopathy (PDR) by 70% over the study period.

The seemingly conflicting findings reflect changes in diabetes treatment and screening for DRD, as well as limitations inherent to retrospective analyses, said Brian VanderBeek, MD, MPH, of Scheie Eye Institute Penn Presbyterian in Philadelphia, at the Association for Research in Vision and Ophthalmology meeting.

“Patients with diabetes are 20% less likely to progress to any form of diabetic retinopathy compared to 2002 but still not quite as good as the 35% decrease we saw from 2010 to 2012,” said VanderBeek. “We have seen a dramatic reduction in progression to vision-threatening disease and its components, including any vision-threatening disease, diabetic macular edema, and proliferative retinopathy.”

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Source: MEDPAGETODAY

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