Major Cause Of Visual Impairment Research Articles

Artificial intelligence in myopia in children: current trends and future directions.

Myopia is one of the major causes of visual impairment globally, with myopia and its complications thus placing a heavy healthcare and economic burden. With most cases of myopia developing during childhood, interventions to slow myopia progression are most effective when implemented early. To address this public health challenge, artificial intelligence has emerged as a potential solution in childhood myopia management. The bulk of artificial intelligence research in childhood myopia was previously focused on traditional machine learning models for the identification of children at high risk for myopia progression. Recently, there has been a surge of literature with larger datasets, more computational power, and more complex computation models, leveraging artificial intelligence for novel approaches including large-scale myopia screening using big data, multimodal data, and advancing imaging technology for myopia progression, and deep learning models for precision treatment. Artificial intelligence holds significant promise in transforming the field of childhood myopia management. Novel artificial intelligence modalities including automated machine learning, large language models, and federated learning could play an important role in the future by delivering precision medicine, improving health literacy, and allowing the preservation of data privacy. However, along with these advancements in technology come practical challenges including regulation and clinical integration.

Prevalence, Characteristics, and Management of Pediatric Ocular Trauma in Riyadh, Saudi Arabia: A Retrospective Analysis.

Ocular trauma is a major cause of visual impairment; however, little is known about its burden in Saudi Arabia. Therefore, this study aimed to determine the epidemiological characteristics of ocular trauma in pediatric patients in Riyadh, Saudi Arabia. Medical records of pediatric patients diagnosed with eye injuries between January 2016 and December 2020 were retrospectively reviewed. Demographic and injury characteristics were collected, and ocular trauma injuries were classified according to the Birmingham Eye Trauma Terminology. A total of 855 injured patients were included in the study, of whom 525 (61.4%) were boys. Patient age ranged from one month to 18 years. Most ocular injuries occurred in children aged 5-9 years. The injuries were more prevalent in boys than in girls. Closed globe injuries accounted for 70% of cases, open globe injuries for 21%, and other injuries for 9%. Most ocular injuries occurred at home (n = 87, 42%), followed by school (n = 61, 30%). These results may inform the implementation and targeting of interventions to reduce or prevent eye injuries in children. Further, they highlight the importance of well-planned prevention programs to prevent eye injuries from occurring in children's daily lives.

A novel variant in the keratin 12 gene in a four-generation Chinese family with high myopia.

High myopia is a major cause of visual impairment, and genetic factors play crucial roles in the pathogenesis. We performed this study to identify candidate genes for the development of high myopia in a four-generation Chinese family with myopia. All family members with myopia and 100 healthy participants were included in this study. Data were obtained on demographics, disease history, and ocular examination results. We performed whole exome sequencing of the genomic DNA and Sanger sequencing to verify the variants. Functional analyses of the variant were performed using software programmes. Nine of thirteen family members were found to have high myopia, amongst which two members were also diagnosed keratoconus. A missense variant in the keratin 12 gene (KRT12, p.Val410Gly) was detected in all high myopia cases but not in other family members without high myopia or the controls. The variant was predicted to be benign by online software programmes. However, modelling of the three-dimensional structure of the protein clearly revealed conformational changes caused by the mutation. A missense mutation in the KRT12 gene was identified in this Chinese family, which may be associated with the pathogenesis of high myopia.

OctoVision: A Smart System for Diabetic Retinopathy Disease Detection

Diabetic retinopathy (DR) is the major cause of vision impairment and blindness in diabetics. Early detection and treatments are critical in preventing irreparable retinal damage. Manual detection of diabetic retinopathy by an ophthalmologist takes a long time, and patients must suffer greatly during this time. This paper presents an automated approach for rapid DR detection using the DenseNet-121 architecture. Our model achieves an accuracy exceeding 80%, with a precision score of 81% and a recall score of 86%, indicating its high effectiveness in detecting DR. Additionally, we developed a server-based implementation where the trained model is deployed. Images captured by a camera are uploaded to a cloud server, which processes them and sends back a diagnostic response. This study contributes to continuing efforts to create efficient and reliable techniques for early DR identification, resulting in earliermanagement and better patient outcomes.

DRD2 activation inhibits choroidal neovascularization in patients with Parkinson's disease and age-related macular degeneration.

Neovascular age-related macular degeneration (nAMD) remains a major cause of visual impairment and puts considerable burden on patients and health care systems. l-DOPA-treated Parkinson's disease (PD) patients have been shown to be partially protected from nAMD, but the mechanism remains unknown. Using murine models that combine 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine-induced (MPTP-induced) PD and laser-induced nAMD with standard PD treatment of l-DOPA/DOPA-decarboxylase inhibitor or specific dopamine receptor inhibitors, we here demonstrate that l-DOPA treatment-induced increase of dopamine-mediated dopamine receptor D2 (DRD2) signaling inhibits choroidal neovascularization independently of MPTP-associated nigrostriatal pathway lesion. Analyzing a retrospective cohort of more than 200,000 patients with nAMD receiving anti-VEGF treatment from the French nationwide insurance database, we show that DRD2 agonist-treated PD patients have a significantly delayed age of onset of nAMD and reduced need for anti-VEGF therapies, similar to the effects of the l-DOPA treatment. While providing a mechanistic explanation for an intriguing epidemiological observation, our findings suggest that systemic DRD2 agonists might constitute an adjuvant therapy to delay and reduce the need for anti-VEGF therapy in patients with nAMD.

A novel fucoxanthin enriched seaweed gummy: Physicochemical qualities and protective effect on UVB-induced retinal müller cells

Retinal disease has become the major cause of visual impairment and vision loss worldwide. Carotenoids, which have the potential antioxidant and eye-care activities, have been widely used in functional foods. Our previous study showed that fucoxanthin could exert photoprotective activity in UVB-induced retinal müller cells (RMCs). To extend the application of fucoxanthin in food industry, fucoxanthin, Undaria pinnatifida pulp (UPP), carrageenan, and other ingredients were mixed to prepare seaweed-flavoured photoprotective gummies in this study. The structural and functional properties of the gummies were then evaluated by physicochemical test and cell experiments. As a result, fucoxanthin enriched gummies presented favourable structural properties and flavour. The hydroxyl groups in fucoxanthin and κ-carrageenan are bonded through hydrogen bonds, forming the spatial network structure inside the gummies, enhancing its elasticity. The gummies showed significant antioxidant effect and alleviated the UVB oxidation damage in RMCs. Moreover, the main ingredients carrageenan and UPP improved the stability of fucoxanthin during in vitro digestion. The results enhance the application of fucoxanthin in functional food with photoprotective activity.

Genetic Insights into Age-Related Macular Degeneration.

One of the major causes of vision impairment among elderly people in developed nations is age-related macular degeneration (AMD). The distinctive features of AMD are the accumulation of extracellular deposits called drusen and the gradual deterioration of photoreceptors and nearby tissues in the macula. AMD is a complex and multifaceted disease influenced by several factors such as aging, environmental risk factors, and a person's genetic susceptibility to the condition. The interaction among these factors leads to the initiation and advancement of AMD, where genetic predisposition plays a crucial role. With the advent of high-throughput genotyping technologies, many novel genetic loci associated with AMD have been identified, enhancing our knowledge of its genetic architecture. The common genetic variants linked to AMD are found on chromosome 1q32 (in the complement factor H gene) and 10q26 (age-related maculopathy susceptibility 2 and high-temperature requirement A serine peptidase 1 genes) loci, along with several other risk variants. This review summarizes the common genetic variants of complement pathways, lipid metabolism, and extracellular matrix proteins associated with AMD risk, highlighting the intricate pathways contributing to AMD pathogenesis. Knowledge of the genetic underpinnings of AMD will allow for the future development of personalized diagnostics and targeted therapeutic interventions, paving the way for more effective management of AMD and improved outcomes for affected individuals.

Systemic Risk Factors in Branch Retinal Vein Occlusion: a Comprehensive Review.

Retinal vein occlusion (RVO) is a major cause of vision impairment globally. Obstruction in the retinal venous system is often due to thrombus formation at arteriovenous crossing points, leading to symptoms localized to the affected retinal area. Systemic conditions like hypertension, diabetes mellitus, dyslipidemia and heart disease are recognized risk factors for RVO, influencing the components of Virchow's triad. This work aims to provide an updated overview of systemic risk factors associated with branch retinal vein occlusion (BRVO) development and to explore management options for the prevention or modification of associated risks. Review of the literature concerning the pathogenesis and risk factors of BRVO, including diabetes mellitus, hyperlipidemia, hematologic conditions, hormonal factors, thyroid disease, and the impact of COVID-19 and related vaccines on BRVO incidence. Diabetes mellitus contributes to BRVO through mechanisms like endothelial dysfunction and thrombogenesis. Hyperlipidemia - through lipid-mediated vascular changes - and hematologic conditions - by predisposing to hypercoagulability - significantly increase BRVO risk. Hormonal imbalances and thyroid diseases also influence BRVO development through their effects on vascular and hemostatic systems. Furthermore, COVID-19 has been identified as a potential risk factor for BRVO, possibly due to its pro- thrombotic effects. Branch retinal vein occlusion represents a complex interplay of systemic and local vascular factors, necessitating comprehensive management strategies. Early detection and modification of risk factors is crucial for preventing vision impairment associated with BRVO. The ongoing pandemic and its systemic implications underscore the importance of continued review into the multifactorial etiology of BRVO and optimization of management strategies to improve patient outcomes.

Rapid survey for assessing effective cataract surgical coverage (eCSC) and effective refractive error coverage (eREC)-Novel indicators of universal eye health.

As per the recent World Health Organization estimates, approximately 2.2 billion people have near and distance vision impairment (VI) globally, and out of this almost 50% is avoidable. The Rapid Assessment of Avoidable Visual Impairment survey was a cross-sectional study conducted in September 2021, using cluster random sampling in 42 clusters with a cluster size of 140, giving a total of 6000 participants. Two teams comprising of trained optometrists and social workers conducted the ocular examination which included unaided, pinhole, and aided visual acuity assessments followed by examination of the anterior segment and lens. Distance visual acuity was measured using simplified tumbling "E" charts of different sizes for VA of 6/12, 6/18, and 6/60. The lens assessment was done in an un-dilated pupil with torch light by the optometrist. Overall, 6520 individuals aged 6 years and above were enumerated, of whom 5440 (83.4%) were examined. The response rate for examination was better among females (93.1%) than males (73.9%), and it decreased from 93.8% in the age group 6-15 years to 77.1% in the 45+ age group. The prevalence of blindness and VI were 0.18% (95% CI: 0.06-0.29) and 4.19% (95%CI: 3.65-4.72), respectively. The major causes of VI in all age groups were uncorrected refractive error (65.4%), cataract (23.7%), cataract surgical complications (2.6%), corneal opacity (0.4%), and other posterior segment diseases (7.5%). The effective cataract surgical coverage (eCSC) was 61.8%, effective refractive error coverage (eREC) for distance vision was 59.8%, and eREC for near vision was 47.0%. The RAAVI methodology is suitable to measure effective coverage in the general population, both for baseline measurement and periodic monitoring. The 2030 targets for the surveyed district are 90% eCSC and 100% eREC. Such exercises need to be conducted in each district of the country to determine the baseline and target values of effective coverage.

Associated factors of diabetic retinopathy in type 1 and 2 diabetes in Limpopo province in South Africa.

Diabetic retinopathy (DR) is the major cause of vision impairment or blindness in individuals who have diabetes. It has accounted for 2.6% of all cases of blindness, and 1.9% of all cases of vision impairments globally. There is a lack of data on the prevalence of diabetic retinopathy and its associated factors amongst diabetic rural populations. Hence, the current study aimed to determine factors associated with diabetic retinopathy (DR) among diabetes mellitus (DM) patients undergoing diabetic therapy. The study was cross-sectional in design and the participants were selected using convenient sampling. STATA version 15 software was used for data analysis. Chi-square was used to compare proportions. Logistic regression was used to determine the relationship between DR and associated risk factors. The prevalence of DR was 35.3%, of which 32% were mild and 3.4% were moderate non-proliferative DR (NPDR). Females were more unemployed than males (32.1% versus 16.8%, p=0.0058). Males were found to drink alcohol (21.8% versus 1.9%, p<0.001) and smoke cigarettes (4% versus 0.3%, p=0.0034) more than females. Being aged ≥ 55 years (OR: 2.7, 95% CI: 1.6-4.4), with matric qualification (OR: 0.6; 95% CI: 0.4-1.0); employed (OR: 1.4, 95% CI: 1.2-1.6); having high systolic blood pressure (OR=1.4, 95%CI=1.1-1.7) were the independent determinants of DR. The prevalence of diabetic retinopathy was 34%. DR was determined by high systolic blood pressure, old age, and employment. Although not statistically significant, gender, hyperglycemic state, poor glycemic control, smoking, and increased body mass index (BMI) were associated with increased risk of developing DR.

Subconjunctival injection of rapamycin-loaded polymeric microparticles for effective suppression of noninfectious uveitis in rats

Noninfective uveitis is a major cause of vision impairment, and corticosteroid medication is a mainstay clinical strategy that causes severe side effects. Rapamycin (RAPA), a potent immunomodulator, is a promising treatment for noninfective uveitis. However, because high and frequent dosages are required, it is a great challenge to implement its clinical translation for noninfective uveitis therapy owing to its serious toxicity. In the present study, we engineered an injectable microparticulate drug delivery system based on biodegradable block polymers (i.e., polycaprolactone-poly (ethylene glycol)-polycaprolactone, PCEC) for efficient ocular delivery of RAPA via a subconjunctival injection route and investigated its therapeutic efficacy in an experimental autoimmune uveitis (EAU) rat model. RAPA-PCEC microparticles were fabricated using the emulsion-evaporation method and thoroughly characterized using scanning electron microscopy, fourier transform infrared spectroscopy, X-ray diffraction, and differential scanning calorimetry. The formed microparticles exhibited slow in vitro degradation over 28 days, and provided both in vitro and in vivo sustained release of RAPA over 4 weeks. Additionally, a single subconjunctival injection of PCEC microparticles resulted in high ocular tolerance. More importantly, subconjunctival injection of RAPA-PCEC microparticles significantly attenuated the clinical signs of EAU in a dose-dependent manner by reducing inflammatory cell infiltration (i.e., CD45+ cells and Th17 cells) and inhibiting microglial activation. Overall, this injectable microparticulate system may be promising vehicle for intraocular delivery of RAPA for the treatment of noninfective uveitis.

Age–period–cohort analysis of the global burden of visual impairment according to major causes: an analysis of the Global Burden of Disease Study 2019

BackgroundCataract, glaucoma and age-related macular degeneration (AMD) are major causes of visual impairment. As these are age-related conditions, the prevalence of associated visual impairment is anticipated to increase as the...

Non-surgical treatment of stage 4A retinopathy of prematurity

BackgroundRetinopathy of prematurity (ROP) is a major cause of visual impairment in premature infants, often requiring surgical interventions in advanced stages. This retrospective case series study investigates non-surgical management for Stage 4A ROP, specifically the use of combined laser therapy and intravitreal anti-vascular endothelial growth factor (VEGF) injections.MethodsTen eyes from five infants with Stage 4A ROP were treated with a combined laser and anti-VEGF approach. Comprehensive follow-up examinations were conducted to evaluate the treatment outcomes.ResultsThe study demonstrated successful retinal attachment without complications, showcasing the efficacy and safety of this non-surgical method. A comparison with surgical interventions highlighted the potential benefits in terms of reduced adverse effects.DiscussionThis combined treatment emerges as a promising first-choice option for Stage 4A ROP, offering rapid regression without surgical intervention, particularly in early stages. However, larger randomized clinical trials are necessary to validate these findings and establish definitive guidelines for managing this complex condition.ConclusionCombined laser and anti-VEGF therapy proved to be an effective and safe non-surgical approach for Stage 4A ROP, with the potential to reduce the need for surgery, especially in its early presentation. Further research is required to confirm these findings and provide comprehensive recommendations for clinical practice.

Diabetic Macular Edema Management: A Review of Anti-Vascular Endothelial Growth Factor (VEGF) Therapies.

Diabetic macular edema (DME) is a major cause of vision impairment in diabetic individuals, characterized by fluid accumulation in the macula due to a breakdown of the blood-retinal barrier (BRB). This review article explores the role of anti-vascular endothelial growth factor (anti-VEGF) therapies in the management of DME. Anti-VEGF treatments, including ranibizumab, bevacizumab, and aflibercept, have revolutionized DME management by targeting VEGF, a key mediator in DME pathogenesis. We critically examined the efficacy of these therapies in reducing macular edema and improving visual acuity, assessed their safety and tolerability, and explored the variability in treatment response. The review highlights the latest advancements and future directions in anti-VEGF therapy, including novel drug delivery systems and emerging treatment paradigms. By providing a comprehensive overview of current anti-VEGF therapies, this review seeks to inform clinical practice, guide future research, and contribute to improved patient outcomes in DME management.

RESTORE VISION: Novel advanced and repurposed therapeutics for vision restoration in a group of severe rare ocular diseases – Short introductory talk

Rare Eye Diseases (REDs) collectively represent a major cause of visual impairment and blindness for children and young adults in Europe. But importantly, REDs also affect adults and the aging population. Defective wound healing at the cornea and ocular surface, excessive inflammation, nerve degeneration, stem cell dysfunction, and aberrant vessel ingrowth are the common denominators in many REDs, representing a critical medical problem and an area of unmet medical need. The onset and progression of many REDs are characterized by common pathophysiologic mechanisms. The goal of many research groups is to disrupt these aberrant mechanisms with the aim of making therapy more effective. Current management is often prohibitively expensive, has low efficacy and leads to debilitating side effects, pointing to a critical medical problem and area of unmet medical need.Here, we will briefly introduce the RESTORE VISION project, which has been recently funded by the European Commission and brings together actors from across the full value chain: 6 leading research institutions, 3 SMEs and a European patient organization. The project will take a ground‐breaking approach to improve eye health by verifying disease pathomechanisms, using cutting‐edge models for each rare disease to test novel and repurposed compounds and determine drug mechanisms of action, formulating compounds as safe eye drop suspensions or subconjunctival drugs, and performing several first‐in‐human trials of novel therapies.

On the structure of eye diseases in children leading to blindness or low vision in various countries of the world

The review presents differences in the nosological structure of ophthalmic pathology leading to childhood blindness and low vision in different countries. Worldwide, 1.4 million children are blind, about three quarters of whom live in the poorest regions of Africa or Asia. In lowincome countries, the congenital cataract is one of the leading causes of visual impairment in children, while retinopathy of prematurity is more common in middle-income countries. Uncorrected refractive errors both in children and adults, remain a major cause of visual impairment in all countries. The development of new technologies and quality medical care impacts the structure of blindness and low vision causes, as well as their geographical specificities. The analysis showed that much effort is required from large-scale state programs of prevention, early diagnosis, treatment and rehabilitation of children with socially significant eye diseases.

The m6A reader YTHDC2 maintains visual function and retinal photoreceptor survival through modulating translation of PPEF2 and PDE6B

Inherited retinal dystrophies (IRDs) are major causes of visual impairment and irreversible blindness worldwide, while the precise molecular and genetic mechanisms are still elusive. N6-methyladenosine (m6A) modification is the most prevalent internal modification in eukaryotic mRNA. YTH domain containing 2 (YTHDC2), an m6A reader protein, has recently been identified as a key player in germline development and human cancer. However, its contribution to retinal function remains unknown. Here, we explore the role of YTHDC2 in the visual function of retinal rod photoreceptors by generating rod-specific Ythdc2 knockout mice. Results show that Ythdc2 deficiency in rods causes diminished scotopic ERG responses and progressive retinal degeneration. Multi-omics analysis further identifies Ppef2 and Pde6b as the potential targets of YTHDC2 in the retina. Specifically, via its YTH domain, YTHDC2 recognizes and binds m6A-modified Ppef2 mRNA at the coding sequence and Pde6b mRNA at the 5′-UTR, resulting in enhanced translation efficiency without affecting mRNA levels. Compromised translation efficiency of Ppef2 and Pde6b after YTHDC2 depletion ultimately leads to decreased protein levels in the retina, impaired retinal function, and progressive rod death. Collectively, our finding highlights the importance of YTHDC2 in visual function and photoreceptor survival, which provides an unreported elucidation of IRD pathogenesis via epitranscriptomics.

Requirement of Site-Specific Tyrosine Phosphorylation of Cortactin in Retinal Neovascularization and Vascular Leakage.

Retinal neovascularization is a major cause of vision impairment. Therefore, the purpose of this study is to investigate the mechanisms by which hypoxia triggers the development of abnormal and leaky blood vessels. A variety of cellular and molecular approaches as well as tissue-specific knockout mice were used to investigate the role of Cttn (cortactin) in retinal neovascularization and vascular leakage. We found that VEGFA (vascular endothelial growth factor A) stimulates Cttn phosphorylation at Y421, Y453, and Y470 residues in human retinal microvascular endothelial cells. In addition, we observed that while blockade of Cttn phosphorylation at Y470 inhibited VEGFA-induced human retinal microvascular endothelial cell angiogenic events, suppression of Y421 phosphorylation protected endothelial barrier integrity from disruption by VEGFA. In line with these observations, while blockade of Cttn phosphorylation at Y470 negated oxygen-induced retinopathy-induced retinal neovascularization, interference with Y421 phosphorylation prevented VEGFA/oxygen-induced retinopathy-induced vascular leakage. Mechanistically, while phosphorylation at Y470 was required for its interaction with Arp2/3 and CDC6 facilitating actin polymerization and DNA synthesis, respectively, Cttn phosphorylation at Y421 leads to its dissociation from VE-cadherin, resulting in adherens junction disruption. Furthermore, whereas Cttn phosphorylation at Y470 residue was dependent on Lyn, its phosphorylation at Y421 residue required Syk activation. Accordingly, lentivirus-mediated expression of shRNA targeting Lyn or Syk levels inhibited oxygen-induced retinopathy-induced retinal neovascularization and vascular leakage, respectively. The above observations show for the first time that phosphorylation of Cttn is involved in a site-specific manner in the regulation of retinal neovascularization and vascular leakage. In view of these findings, Cttn could be a novel target for the development of therapeutics against vascular diseases such as retinal neovascularization and vascular leakage.

MiR-423-5p promotes Müller cell activation via targeting NGF signaling in diabetic retinopathy

AimsDiabetic retinopathy (DR) is a common microvascular complication of diabetes mellitus and one of the major causes of visual impairment and blindness in industrialized countries. The early neuro-glial perturbations, especially retinal Müller cells (rMC) activation, intimately associated with the vascular alterations. MicroRNAs (miRNAs) have been reported to play critical roles in the progression of DR. Here, we aimed to further explore the role and underlying mechanism of miR-423-5p in Müller cell activation in streptozotocin (STZ)-induced diabetic mice and oxygen-induced retinopathy (OIR) model. Materials and methodsRetinal histology, optical coherence tomography (OCT) and biochemical markers were assessed. Key findingsOur data revealed that the expression of miR-423-5p was significantly increased under high-glucose environment. We also demonstrated that miR-423-5p overexpression markedly accelerated retinal vascular leakage, leukocytosis, and rMC activation. This response was ameliorated in animals pre-treated with the inhibition of miR-423-5p. Specifically, miR-423-5p bound to the nerve growth factor (NGF) 3′ UTR region to induce its silencing. NGF inhibition significantly promoted retinal microvascular dysfunction. SignificanceThese findings demonstrate that miR-423-5p is a critical miRNA that promotes microvascular dysfunction in DR.

Prevalence and Risk Factors of Retinopathy in Type 1 Diabetes: A Cross-Sectional Study.

Introduction Diabetic retinopathy (DR) is a severe complication of diabetes. It remains a major cause of visual impairment and blindness, especially in young people. It is a silent affection that only becomes symptomatic at the onset of complications. Our study aimed to estimate the prevalence of retinopathy in patients with type 1 diabetes mellitus (T1DM) and evaluate the associated risk factors in our population. Materials and methods A descriptive and analytical study, with a cross-sectional study involving 359 patients with type 1 diabetes, was followed up in the Department of Endocrinology, Diabetology, and Nutrition of the University Hospital Center Mohammed VI Oujda, Morocco. Data were collected from medical records and analyzed by binary logistic regression using IBM Corp. Released 2012. IBM SPSS Statistics for Windows, Version 21.0. Armonk, NY: IBM Corp. Results The average age of our patients was 24.2 ± 11.4 years. The mean duration of diabetes was 11.8±4.4 years. The average glycated hemoglobin (HbA1c) at admission was 10.1 ± 2.4%. DR was found in 30% of patients, including 28.6% with minimal non-proliferative diabetic retinopathy (NPDR), 19.1% with moderate NPDR, 19.1% with severe NPDR, and 33.3% with proliferative DR. Patients with diabetic retinopathy appear to have a longer duration of diabetes (13.05±9.05 vs. 10.6±8.07 years). The longer duration of diabetes, neuropathy, and nephropathy was significantly associated with diabetic retinopathy (p=0.02, p=0.002, and p=0.0001, respectively). Conclusion The frequency of diabetic retinopathy increases with age, poor glycemic control, and the duration of diabetes. Therefore, cooperation between diabetologists and ophthalmologists is essential for making an early diagnosis and providing early treatment.