Prevalence and incidence of diabetic retinopathy (DR) in the UK population of Gloucestershire.

Peter H Scanlon,Sobha Sivaprasad,Victor Chong,Clare Bailey,Clareece R Nevill,Michael Ehrlich,Sonia S Maruti,Irene M Stratton,Elvira L Massó‐González

doi:10.1111/aos.14927

Abstract

PurposeTo estimate prevalence and incidence of diabetic retinopathy (DR) in a UK region by severity between 2012 and 2016 and risk factors for progression to proliferative DR (PDR).MethodsElectronic medical records from people with diabetes (PWD) ≥18 years seen at the Gloucestershire Diabetic Eye Screening Programme (GDESP) and the hospital eye clinic were analysed (HEC). Prevalence and incidence of DR per 100 PWD (%) by calendar year, grade and diabetes type were estimated using log‐linear regression. Progression to PDR and associated risk factors were estimated using parametric survival analyses.ResultsAcross the study period, 35 873 PWD had at least one DR assessment. They were aged 66 (56–75) years (median (interquartile range)), 57% male, 5 (1–10) years since diabetes diagnosis, 93% Type 2 diabetes. Prevalence of DR decreased from 38.9% (95% CI: 38.1%, 39.8%) in 2012 to 36.6% (95% CI: 35.9%, 37.3%) in 2016 (p < 0.001). Incidence of any DR decreased from 10.9% (95% CI: 10.4%, 11.5%) in 2013 to 8.5% (95% CI: 8.1%, 9.0%) in 2016 (p < 0.001). Prevalence of PDR decreased from 3.5% (95% CI: 3.3%, 3.8%) in 2012 to 3.1% (95% CI 2.9%, 3.3%) in 2016 (p = 0.008). Incidence of PDR did not change over time. HbA1c and bilateral moderate–severe NPDR were statistically significant risk factors associated with progression to PDR.ConclusionsIncidence and prevalence of DR decreased between 2012 and 2016 in this well‐characterized population of the UK.

Highlights

In England and Wales, 3.54 million people (7% of the population) were registered with diabetes in 2018–2019 (NDA 2020).Diabetic retinopathy (DR) is a microvascular complication of diabetes which remains a common cause of blindness and vision loss among people of working age in the UK (Quartilho et al 2016).It is important that epidemiological data on DR are regularly updated as the numbers of people with diabetes increase and the control of modifiable risk factors improves
When all mandatory fields are completed, an algorithm in the electronic medical record (EMR) system calculates the grade of DR and maculopathy according to the Early Treatment of Diabetic Retinopathy Study (ETDRS 1991) and NHS Diabetic Eye Screening Programme (Scanlon 2017) classifications of DR
Whilst there are many studies in the literature describing prevalence and incidence of DR, there are few like Gloucestershire where there is universal health care, free at the point of delivery, with a countywide screening service

Summary

Introduction

In England and Wales, 3.54 million people (7% of the population) were registered with diabetes in 2018–2019 (NDA 2020).Diabetic retinopathy (DR) is a microvascular complication of diabetes which remains a common cause of blindness and vision loss among people of working age in the UK (Quartilho et al 2016).It is important that epidemiological data on DR are regularly updated as the numbers of people with diabetes increase and the control of modifiable risk factors improves. Many people quote epidemiological data from the Wisconsin Epidemiological Studies (Klein et al, 1984a, 1984b) which commenced using a stratified sample in southern Wisconsin in 1980. In this population, 22.5% of the younger age group

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