Cited by 1,196Retinal Diseases and TreatmentsRetinal Imaging and AnalysisDiabetes Management and Research

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Prevalence of Diabetic Retinopathy in the United States, 2005-2008

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Zhang, Xinzhi, Saaddine, Jinan B., Chou, Chiu-Fang, Cotch, Mary Frances, Cheng, Yiling J., Geiss, Linda S., Gregg, Edward W., Albright, Ann L., Klein, Barbara E. K., Klein, Ronald·2010·JAMA

DOI 10.1001/jama.2010.1111PMC PMC2945293

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Abstract

CONTEXT: The prevalence of diabetes in the United States has increased. People with diabetes are at risk for diabetic retinopathy. No recent national population-based estimate of the prevalence and severity of diabetic retinopathy exists. OBJECTIVES: To describe the prevalence and risk factors of diabetic retinopathy among US adults with diabetes aged 40 years and older. DESIGN, SETTING, AND PARTICIPANTS: Analysis of a cross-sectional, nationally representative sample of the National Health and Nutrition Examination Survey 2005-2008 (N = 1006). Diabetes was defined as a self-report of a previous diagnosis of the disease (excluding gestational diabetes mellitus) or glycated hemoglobin A(1c) of 6.5% or greater. Two fundus photographs were taken of each eye with a digital nonmydriatic camera and were graded using the Airlie House classification scheme and the Early Treatment Diabetic Retinopathy Study severity scale. Prevalence estimates were weighted to represent the civilian, noninstitutionalized US population aged 40 years and older. MAIN OUTCOME MEASUREMENTS: Diabetic retinopathy and vision-threatening diabetic retinopathy. RESULTS: The estimated prevalence of diabetic retinopathy and vision-threatening diabetic retinopathy was 28.5% (95% confidence interval [CI], 24.9%-32.5%) and 4.4% (95% CI, 3.5%-5.7%) among US adults with diabetes, respectively. Diabetic retinopathy was slightly more prevalent among men than women with diabetes (31.6%; 95% CI, 26.8%-36.8%; vs 25.7%; 95% CI, 21.7%-30.1%; P = .04). Non-Hispanic black individuals had a higher crude prevalence than non-Hispanic white individuals of diabetic retinopathy (38.8%; 95% CI, 31.9%-46.1%; vs 26.4%; 95% CI, 21.4%-32.2%; P = .01) and vision-threatening diabetic retinopathy (9.3%; 95% CI, 5.9%-14.4%; vs 3.2%; 95% CI, 2.0%-5.1%; P = .01). Male sex was independently associated with the presence of diabetic retinopathy (odds ratio [OR], 2.07; 95% CI, 1.39-3.10), as well as higher hemoglobin A(1c) level (OR, 1.45; 95% CI, 1.20-1.75), longer duration of diabetes (OR, 1.06 per year duration; 95% CI, 1.03-1.10), insulin use (OR, 3.23; 95% CI, 1.99-5.26), and higher systolic blood pressure (OR, 1.03 per mm Hg; 95% CI, 1.02-1.03). CONCLUSION: In a nationally representative sample of US adults with diabetes aged 40 years and older, the prevalence of diabetic retinopathy and vision-threatening diabetic retinopathy was high, especially among Non-Hispanic black individuals.

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Authors: Zhang, X., Saaddine, J. B., Chou, C.-F., Cotch, M. F., Cheng, Y. J., Geiss, L. S., Gregg, E. W., Albright, A. L., Klein, B. E. K., & Klein, R.
Affiliations: Centers for Disease Control and Prevention (US)
Corresponding author: Zhang, Xinzhi
ORCID: Zhang, Xinzhi
Saaddine, Jinan B.
Cotch, Mary Frances
Cheng, Yiling J.
Geiss, Linda S.
Gregg, Edward W.
Klein, Barbara E. K.
Klein, Ronald
Venue: JAMA
Publisher: American Medical Association (AMA)
Published: 2010-08-11
Volume: 304
Issue: 6
Pages: 649
ISSN: 0002-9955 (ISSN-L)
0098-7484
DOI: 10.1001/jama.2010.1111
PMC: PMC2945293
OpenAlex: W2049036672
Cited by: 1,196
References: 41
Citations by year: 2026: 26 · 2025: 62 · 2024: 83 · 2023: 109 · 2022: 82 · 2021: 131 · 2020: 104 · 2019: 91 · 2018: 71 · 2017: 70 · 2016: 66 · 2015: 81 · 2014: 62 · 2013: 65 · 2012: 59
FWCI: 55.13
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Locations: JAMA (publishedVersion)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
Funders: National Institutes of Health (Z99 EY999999)
U.S. Public Health Service (05FED47304)
National Eye Institute (ZIAEY000402, Z01EY000402)
Topics: Health Sciences › Medicine › Ophthalmology › Retinal Diseases and Treatments
Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Retinal Imaging and Analysis
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
Keywords: diabetic retinopathy, prevalence, vision-threatening diabetic retinopathy, diabetes mellitus, risk factors, sex differences, racial disparities, non-Hispanic Black adults, fundus photography, adults aged 40 and older, United States adults
MeSH terms: Adult, Aged, Black or African American, Cross-Sectional Studies, Diabetic Retinopathy, Female, Humans, Male, Middle Aged, Nutrition Surveys, Risk Factors, United States, Vision Disorders, Prevalence

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