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Prevalence of and Risk Factors for Diabetic Macular Edema in the United States
Open accessAbstract
IMPORTANCE: Diabetic macular edema (DME) is a leading cause of vision loss in persons with diabetes mellitus. Although there are national estimates for the prevalence of diabetic retinopathy and its risk factors among persons with diabetes, to our knowledge, no comparable estimates are available for DME specifically. OBJECTIVES: To estimate the prevalence of DME in the US population and to identify associated risk factors. DESIGN, SETTING, AND PARTICIPANTS: A cross-sectional analysis of 1038 participants aged 40 years or older with diabetes and valid fundus photographs in the 2005 to 2008 National Health and Nutrition Examination Survey. MAIN OUTCOMES AND MEASURES: The overall prevalence of DME and its prevalence according to age, race/ethnicity, and sex. RESULTS: Of the 1038 persons with diabetes analyzed for this study, 55 had DME, for an overall weighted prevalence of 3.8% (95% CI, 2.7%-4.9%) or approximately 746, 000 persons in the US 2010 population aged 40 years or older. We identified no differences in the prevalence of DME by age or sex. Multivariable logistic regression analysis showed that the odds of having DME were higher for non-Hispanic blacks than for non-Hispanic whites (odds ratio [OR], 2.64; 95% CI, 1.19-5.84; P = .02). Elevated levels of glycosylated hemoglobin A1c (OR, 1.47; 95% CI, 1.26-1.71 for each 1%; P < .001) and longer duration of diabetes (OR, 8.51; 95% CI, 3.70-19.54 for ≥ 10 vs <10 years; P < .001) were also associated with DME prevalence. CONCLUSIONS AND RELEVANCE: These results suggest a greater burden of DME among non-Hispanic blacks, individuals with high levels of hemoglobin A1c, and those with longer duration of diabetes. Given recent treatment advances in reducing vision loss and preserving vision in persons with DME, it is imperative that all persons with diabetes receive early screening; this recommendation is even more important for those at higher risk for DME.
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“For example, African-American patients are three times more likely to present with diabetic macular edema (DME), 1.6 times more likely to present with vision-threatening diabetic retinopathy, and 4 times more likely to present with vision loss as compared to non-Hispanic Whites9–12.”
From Autonomous AI-assisted diabetic retinopathy screening at primary care is associated with increased presentation to eye care by at risk patients (2026) · cites this paper as [10]
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In the citing paper
“For example, African-American patients are three times more likely to present with diabetic macular edema (DME), 1.6 times more likely to present with vision-threatening diabetic retinopathy, and 4 times more likely to present with vision loss as compared to non-Hispanic Whites9–12.”
From Autonomous AI-assisted diabetic retinopathy screening at primary care is associated with increased presentation to eye care by at risk patients (2026) · cites this paper as [10]
Experimental — accuracy not yet measuredThe check wasn’t confident either way, so it gives no verdict — never disputed.
In the citing paper
“For example, African-American patients are three times more likely to present with diabetic macular edema (DME), 1.6 times more likely to present with vision-threatening diabetic retinopathy, and 4 times more likely to present with vision loss as compared to non-Hispanic Whites9–12.”
From Autonomous AI-assisted diabetic retinopathy screening at primary care is associated with increased presentation to eye care by at risk patients (2026) · cites this paper as [10]
Experimental — accuracy not yet measured
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Citations
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“Optical coherence tomography (OCT), which uses laser to capture high-resolution retina images in vivo [1], is now a standard of care for guiding the diagnosis and treatment of some of the leading causes of blindness worldwide, including age-related macular degeneration (AMD) and diabetic macular edema (DME) [2-3].”
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“It is the leading cause of new blindness in patients under 65 years of age [22].”
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“The report of International Diabetes Federation (IDF) (2013), reveals that approximately 50% diabetes infected world populations resides in only three countries: China (98.4 million), India (65.1 million) and the USA (24.4 million) (Varma et al .”
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“DME causes a severe vision disturbance and is a major cause of the blindness associated with the increasing prevalence of diabetes around the world [1,2].”
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“Diabetic macular edema (DME) is the most common sight-threatening complication of diabetes afflicting working-age adults [1,2].”
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“Varma et al (3) reported that in the US population the overall weighted prevalence of DME among persons with diabetes mellitus aged ≥40 years is 3.”
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“In a study carried out in the USA by Varma et al. (2014), a cross-sectional analysis of 1038 individuals with diabetes participating in the 2005 to 2008 National Health and Nutrition Examination Survey showed an overall weighted prevalence of 3.8% for DME, with higher rates amongst non-Hispanic…”
BackgroundInfluential
Metadata
- Authors
- Varma, R., Bressler, N. M., Doan, Q. V., Gleeson, M., Danese, M., Bower, J. K., Selvin, E., Dolan, C., Fine, J., Colman, S., & Turpcu, A.
- Affiliations
- University of Southern California (US)
- Johns Hopkins University (US)
- Outcomes Insights, Inc, Westlake Village, California
- The Ohio State University (US)
- Genentech (US)
- Corresponding author
- Varma, Rohit
- ORCID
- Venue
- JAMA Ophthalmology
- Publisher
- American Medical Association (AMA)
- Published
- 2014-11-01
- Volume
- 132
- Issue
- 11
- Pages
- 1334
- ISSN
- 2168-6165 (ISSN-L)
- PMC
- PMC4576994
- OpenAlex
- W2075206985
- Cited by
- 423
- References
- 38
- Citations by year
- 2026: 26 · 2025: 38 · 2024: 38 · 2023: 38 · 2022: 62 · 2021: 31 · 2020: 42 · 2019: 28 · 2018: 26 · 2017: 29 · 2016: 32 · 2015: 30 · 2014: 2
- FWCI
- 29.07
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- JAMA Ophthalmology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Heart, Lung, and Blood Institute (T32HL007024)
- 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 macular edema, prevalence, risk factors, diabetes mellitus, racial disparities, non-Hispanic blacks, HbA1c, diabetes duration, vision loss, diabetic retinopathy, vision screening
- MeSH terms
- Adult, Aged, Blood Glucose, Cross-Sectional Studies, Diabetic Retinopathy, Ethnicity, Female, Health Surveys, Glycated Hemoglobin, Humans, Macular Edema, Male, Middle Aged, Nutrition Surveys, Risk Factors, United States, Prevalence, Age Distribution, Sex Distribution
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