Diabetic Retinopathy: EpidemiologyDiabetic Retinopathy: Epidemiology Prof S. Resnikoff MD PhD ICO...
Transcript of Diabetic Retinopathy: EpidemiologyDiabetic Retinopathy: Epidemiology Prof S. Resnikoff MD PhD ICO...
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Diabetic Retinopathy: Epidemiology
Prof S. Resnikoff MD PhD
ICO Director of Eye Care Delivery - Geneva
BHVI - Sydney
2nd International Course in Visual Health
February 14th – 15th, 2020, Querétaro
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Outline
1. Epidemiology of Diabetes
2. Risk factors for developing DR and complications
3. Burden: absolute numbers and prevalence trends
4. Morbidity vs Disability
5. Estimating magnitude and treatment needs
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Diabetes MellitusNo Diabetic Retinopathy
without Diabetes Mellitus
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463 million people living with Diabetes (2019)
IDF Atlas 2019
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Prevalence of Diabetes (age-standardized, 2019)
IDF Atlas 2019
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Risk Factors for DR and complications
• Type 1 Diabetes >>> Type 2 Diabetes
• Risk of PDR x 15
• Risk of DME x 5
• Ethnicity:
• Highest Risk: Afro-Americans
• Lowest Risk: Asians
• Diabetes duration (especially > 20yrs)
• Hyperglycemia HbA1C
• Hypertension
• Dyslipidemia
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RE
Other
AMD
Glaucoma
CODR
Tra
RE
Other
AMD
Glaucoma CODR Tra
RE
Other
AMD
Glaucoma
CODR Tra
Cataract Cataract Cataract
Blindness
(PVA < 0.05)
Mod. & Severe VI
(PVA 0.3 – 0.05)
Visual Impairment
(PVA < 0.3)
Diabetic Retinopathy: 6rd cause of Blindness
and Visual Impairment (World, 2015)
2.2% 1.5%1.3%
0.8 Million 2.9 Million 3.7 Million
Probably Underestimated because of survey methodology
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Prevalence of VI due to DR
0.0%
1.0%
2.0%
3.0%
4.0%
5.0%
6.0%
1990 1995 2000 2005 2010 2015 2020
Trends 1990 – 2020
CE Eur HIC LAC NAME
SA WP SSA Wolrd
China
World
Eastern EU
HIC
S. Asia
Lat Am
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-100% -50% 0% 50% 100%
Cat
DR
AMD
Other
Glau
RE
CO
Tra
Changes in Prevalence 1990 - 2020
DR
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Morbidity: people having DR (any stage)
• Global estimate: 160 million people (aged 20 -
70) with any stage of Diabetic Retinopathy in
2020*
Yau JWY et al.. Global Prevalence and Major Risk Factors of Diabetic Retinopathy. Diabetes Care, 2012
Vision Impaired
3.7 Million (2%)
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Estimating DR magnitude
Prevalence among people with Diabetes:
• Any DR = 35.4%
• Vision Threatening DR = 11.7%
• Proliferative DR (PDR) = 7.2%
• Macular Oedema (DME) = 7.5%
* Yau JW, Rogers SL, Kawasaki R, et al.
Global Prevalence and Major Risk Factors of Diabetic Retinopathy. Diabetes Care. Mar 2012;35(3):556-564.
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Estimating DR magnitude in Mexico
Estimated number of patients in Mexico (Prev: 15.2%):
• Any DR: 12.8 million DM x 35.4% = 4.5 million
• Vision Threatening DR: 12.8 x 11.7% = 1.5 million
• Proliferative DR (PDR): 12.8 x 7.2% = 900,000
• Macular Oedema (DME): 12.8 x 7.5% = 960,000
Yau JWY, et al. 2012 and IDF Atlas 2019
13 million patients to screen/year
1.5 million chronic care patients to manage