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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
Cites
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Items 201–300 of 422
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Rush, R. B., & Rush, S. W. (2021) · Clinical ophthalmology · doi:10.2147/opth.s320214 · Cited by 8
“Introduction Diabetic retinopathy is the number one cause of vision loss in working-age adults, and macular edema is the most frequent cause of visual impairment in diabetic patients.(1) Diabetic macular edema (DME) has been treated by a number of different modalities including focal and grid laser,(2) intravitreal co…”
BackgroundEldem, B. M., Özdek, Ş., Saatçi, A. O., Özmert, E., Ulay, E., & Nomak, G. (2017) · Journal of Ophthalmology · doi:10.1155/2017/3596817 · Cited by 8
“This seems notable given the previously reported association of elevated levels of HbA1c with DME prevalence and deterioration, particularly for patients whose HbA1c level is above 7% and who have had diabetes for a long time [1, 16, 17].”
Improvement of Recalcitrant Diabetic Macular Edema After Peritoneal Dialysis
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“DME affects around 7.5% of patients with diabetes and is characterized by fluid accumulation in the macular region due to the breakdown of the blood–retinal barrier, leading to central vision loss and significant functional disability [1–3].”
InfluentialStockwell, A., Chang, M., Mahajan, A., Forrest, W. F., Anegondi, N., Pendergrass, R. K., Selvaraj, S. K., Reeder, J., Wei, E., Iglesias, V. A., et al. (2023) · PLoS Genetics · doi:10.1371/journal.pgen.1010609 · Cited by 8
“Diabetic patients with African American ancestry have the greatest risk of developing DME of all populations in the United States, estimated at three times greater than those of European-descent [3].”
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Nomogram-based prediction of clinically significant macular edema in diabetes mellitus patients
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“Most previous studies on DME or CSME simply focus on analyzing the risk factors, while few of them developed a nomogram or validated it [20, 21].”
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“DME left untreated is one of the most common causes of vision loss in people with diabetic eye disease[4].”
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“Multiple large epidemiologic studies have shown that systemic factors such as glycosylated hemoglobin (HbA1c) level or estimated glomerular filtration rate (eGFR) could affect vision by increasing the risk of DME [15].”
BackgroundTherapeutic strategies targeting ocular vasculopathies: Current advances and emerging challenges
Du, J. L., & Ronco, C. (2025) · Drug Discovery Today · doi:10.1016/j.drudis.2025.104496 · Cited by 7
Diabetic Retinopathy in Hispanics: A Perspective on Disease Burden
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Real-world Outcomes among Eyes with Center-Involving Diabetic Macular Edema and Good Visual Acuity
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“In the United States, 1 in every 25 patients with DM aged ≥ 40 years is believed to have DME in at least 1 eye, which equates to an estimated 746,000 people.(4) Over the past decade, treatment of center-involving DME (ci-DME), has evolved from laser photocoagulation to intravitreal anti-vascular endothelial growth fac…”
BackgroundDiabetic retinopathy among Omanis: Prevalence and clinical profile
Agroiya, P., Alrawahi, A. H., Pambinezhuth, F., & Busaidi, N. A. (2020) · Oman Journal of Ophthalmology · doi:10.4103/ojo.ojo_225_2019 · Cited by 9
INCIDENCE OF NEW DIABETIC MACULAR EDEMA IN FELLOW EYES OF PATIENTS IN THE VISTA AND VIVID STUDIES
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Vitreomacular interface after anti-VEGF injections in diabetic macular edema
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“Background Diabetic macular edema (DME) is the most common cause of visual impairment in patients with diabetes mellitus, occurring in approximately 7–8 % of the diabetic population [1].”
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“Based on the above, although the contemporary belief is that fingolimod should be discontinued immediately after the appearance of ME, we believe it is necessary to acknowledge cases like the present case, in which administration of fingolimod was continued.”
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“llion in 2050 [3]. Globally, 8.7% of the population is expected to have agerelated macular degeneration (AMD) and the numbers are projected to increase from 196 million in 2020 to 288 million in 2040 [4]. For each decade of age after 40, the prevalence of blindness and low vision increases by a factor of three [5]. Ea…”
BackgroundInfluentialBiologic Therapy and Treatment Options in Diabetic Retinopathy with Diabetic Macular Edema
Nissen, T. P. H., Vorum, H., & Aasbjerg, K. (2020) · Current Drug Safety · doi:10.2174/1574886315666200902154322 · Cited by 5
FLeak-Seg: Automated Fundus Fluorescein Leakage Segmentation via Cross-Modal Attention Learning
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Kolomeyer, A. M., Eichenbaum, D. A., Kiernan, D. F., Suñer, I. J., & Hariprasad, S. M. (2023) · Ophthalmic surgery, lasers & imaging retina · doi:10.3928/23258160-20230215-01 · Cited by 5
Association Between Tobacco Smoking and the Development of Diabetic Macular Edema
Thomson, K. B., Khalid, S. I., Sabherwal, N., & Heiferman, M. J. (2024) · Journal of VitreoRetinal Diseases · doi:10.1177/24741264241269479 · Cited by 6
“11,12 This consistency in results across studies using slightly different study populations, covariates, and statistical techniques strengthens the evidence of a true association between smoking and a decreased risk for DME.”
InfluentialLi, L., Hu, L., Gao, F., Shi, Y., Chen, C., Zhu, X., Liu, J., & Li, X. (2024) · Photodiagnosis and Photodynamic Therapy · doi:10.1016/j.pdpdt.2024.104385 · Cited by 5
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Aflibercept for the Treatment of Diabetic Macular Edema
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“By observing the severity of fluores-cein leakage, calculating its size, and determining its location on the retina, ophthalmologists can comprehensively evaluate retinopathy and its development tendency [6].”
BackgroundToto, L., D’Aloisio, R., Quarta, A., Libertini, D., D’Onofrio, G., Nicola, C. D., Romano, A., & Mastropasqua, R. (2022) · Journal of Clinical Medicine · doi:10.3390/jcm11175200 · Cited by 5
“DMO, which can occur at any stage of DR, is one of the leading causes of legal blindness in the working-age population and is the earliest and most common cause of visual loss in patients with DR [5].”
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Diabetic Retinopathy Early Detection Based on OCT and OCTA Feature Fusion
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“(1,3,4,5) The prevalence in Africa is reported to be higher and ranges from 8.”
BackgroundInfluentialPrevalence and Health Care Disparities of Retinal Conditions
Liu, T. Y. A., Ko, S., Rosettie, K. L., Bonine, N. G., Pletcher, A., Burke-Conte, Z., Flaxman, A. D., Lei, J., Oron, A. P., Borkar, D. S., et al. (2026) · JAMA Ophthalmology · doi:10.1001/jamaophthalmol.2026.0319 · Cited by 4
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“Diabetic macular oedema (DMO) is a well-known sight-threatening complication of diabetes mellitus (DM) [1].”
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“Associative risk factors for DMO include high haemoglobin A 1C levels and those with longer duration of DM [2].”
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Yan, A., Jones, C. E., Demirel, S., & Chhablani, J. K. (2024) · Graefe s Archive for Clinical and Experimental Ophthalmology · doi:10.1007/s00417-024-06595-7 · Cited by 4
“DME can develop at any phase of diabetic retinopathy with an increased risk in non-Hispanic blacks as well as patients with higher levels of hemoglobin A1c or a longer duration of diabetes [3].”
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“States alone, approximately 1 of every 25 persons above the age of 40 with diabetes has DME in at least 1 eye [3].”
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“In diabetics of Latin American origin, the prevalence of macular edema ranges between 5% and 10% [10] [11].”
BackgroundRetinal Ganglion Cell Complex Changes after Intravitreal Bevacizumab for Diabetic Macular Edema
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Factors associated with diabetic macular edema in patients with proliferative diabetic retinopathy
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Real-world outcomes of faricimab in treating diabetic macular edema up to two years
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“[2] The significant morbidity of the condition has led to extensive research on treatment options.”
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“…is de fi ned as retinal edema caused by diabetes-induced microvascular complication, increases with the duration of diabetes and progression of DR. [9, 10] Therefore, the cumulative increase in retinal thickening with the progression of retinopathy in humans is presumably due to edematous swelling…”
Yu, C. W., Nanji, K., Garg, A., Zaman, M., Jomy, J., El‐Sayes, A., Sun, C. Q., Bhat, S., Phillips, M., Zeraatkar, D., et al. (2025) · Ophthalmology · doi:10.1016/j.ophtha.2025.08.004 · Cited by 3
Diabetic Macular Edema in Diabetological Practices
Michelson, G., & Forst, T. M. (2020) · Klinische Monatsblätter für Augenheilkunde · doi:10.1055/a-1194-5211 · Cited by 3
“The prevalence levels determined correlate well with those found in the literature [4].”
ResultArslan, S. (2022) · Acta Endocrinologica (Bucharest) · doi:10.4183/aeb.2022.278 · Cited by 3
Xu, D., Zhu, T., Huang, L., Wang, X., & Chen, M. (2024) · Medicine · doi:10.1097/md.0000000000034583 · Cited by 3
“[2] DME is also the most common cause of vision loss in patients with DM. [3] There are various clinical treatments for DME, [4] among which anti-vascular endothelial growth factor (VEGF) drugs remain the first-line treatment for DME.”
BackgroundParimi, V., Elsner, A. E., Gast, T. J., Chen, Z., Baskaran, K., Alhamami, M. A., Litvin, T. V., Ozawa, G. Y., & Cuadros, J. A. (2024) · Optometry and Vision Science · doi:10.1097/opx.0000000000002096 · Cited by 3
Aflibercept for diabetic macular oedema: a Meta-analysis of randomized controlled trials
Nguyen, C. L., Lindsay, A., Wong, E. H., & Chilov, M. N. (2018) · International Journal of Ophthalmology · doi:10.18240/ijo.2018.06.18 · Cited by 3
Tiosano, L., Ehrlich, R., Barak, Y., Katz, H., Pokroy, R., Jaouni, T., Levy, J., Hanhart, J., Segal, O., Shulman, S., et al. (2020) · Eye · doi:10.1038/s41433-020-0901-5 · Cited by 3
Miller, C. G., Budoff, G., Jeng-Miller, K. W., Fine, H. F., Roth, D. B., & Prenner, J. L. (2016) · Ophthalmic surgery, lasers & imaging retina · doi:10.3928/23258160-20160601-06 · Cited by 3
Carroll, R. M., Yu, Y., & VanderBeek, B. L. (2019) · European Journal of Ophthalmology · doi:10.1177/1120672119827856 · Cited by 3
Tessier, M., Meillon, C., Creuzot-Garcher, C. P., Bron, A. M., & Nguyen, P. (2020) · Journal Français d Ophtalmologie · doi:10.1016/j.jfo.2019.10.018 · Cited by 3
Iris thickness measurements in patients with diabetic retinopathy
Demirtaş, Ö., Pekel, G., Pekel, E., & Çetin, E. N. (2020) · European Journal of Ophthalmology · doi:10.1177/1120672120972623 · Cited by 3
Long-term hemodialysis improved and stabilized diabetic macular edema: two case reports
Fan, W. (2021) · International Journal of Ophthalmology · doi:10.18240/ijo.2021.03.23 · Cited by 3
Arslan, S., Kırağı, D., Kadayıfçılar, S., & Samur, G. (2020) · Sağlık Akademisi Kastamonu · doi:10.25279/sak.757689 · Cited by 6
Syriga, M., Ioannou, Z., Pitsas, C., Dagalaki, I., & Karampelas, M. D. (2022) · International Ophthalmology · doi:10.1007/s10792-021-02162-9 · Cited by 3
“Accordingly, among Asian countries, India and China have recorded the highest rate of DR [7], while in Western populations the disease prevalence was significantly higher in Hispanics and ethnic blacks [8, 9].”
BackgroundHyperreflective material serves as a potential biomarker of dyslipidemia in diabetic macular edema
Li, Z., Deng, X., Lu, T., Zhou, L., Xiao, J., Lan, Y., & Jin, C. (2022) · Photodiagnosis and Photodynamic Therapy · doi:10.1016/j.pdpdt.2022.102903 · Cited by 3
Lee, H. J., Bae, K., Yoon, C. K., Park, U. C., Park, K. H., & Lee, E. K. (2024) · Scientific Reports · doi:10.1038/s41598-024-55078-6 · Cited by 2
An Extended Generalized Prandtl-Ishlinskii Hysteresis Model for I2RIS Robot
Yue, Y., Esfandiari, M., Du, P., Gehlbach, P. L., Jinno, M., Munawar, A., Kazanzides, P., & Iordachita, I. I. (2025) · IFAC-PapersOnLine · doi:10.1016/j.ifacol.2025.12.257 · Cited by 2
“DME is a major cause of vision loss among diabetic patients (Varma et al. (2014)).”
Factors Associated With the Presence of Foveal Bulge in Eyes With Resolved Diabetic Macular Edema
Wu, Q., Hu, Y., Liu, B., Lin, Z., Xiao, Y., Zeng, X., Fang, Y., Yan, Y., Ye, Y., Yan, M., et al. (2022) · Frontiers in Medicine · doi:10.3389/fmed.2021.755609 · Cited by 2
Li, J., Harrison, W. W., & Cho, S. K. (2022) · Diabetes Epidemiology and Management · doi:10.1016/j.deman.2022.100070 · Cited by 3
COVID-19 Pandemic Lockdowns’ Impact on Visual Acuity of Diabetic Macular Edema: A Large Cohort
Gomel, N., Shor, R., Lippin, N., Segal, O., Greenbaum, E., Schwartz, S., Trivizki, O., Loewenstein, A., & Rabina, G. (2022) · Ophthalmologica · doi:10.1159/000527942 · Cited by 2
Haque, M. M., Gumbie, M., Gu, M., & Dissanayake, G. S. (2022) · Australian Health Review · doi:10.1071/ah22198 · Cited by 2
Hidaka, Y., Kuriyama, A., Nishinaka, A., Takahashi, K., Nakaya, S., Kubota, T., Nakamura, S., Shimazawa, M., & Hara, H. (2023) · BPB Reports · doi:10.1248/bpbreports.6.2_47 · Cited by 2
Torres-Arellano, J. M., Tornero-Jimenez, A., Sánchez‐Ríos, A., Olvera‐Montaño, O., & Muñoz‐Villegas, P. (2023) · Ophthalmology and Therapy · doi:10.1007/s40123-023-00787-w · Cited by 2
“In the eye, longer duration of diabetes is a risk factor for the development of DR and DME [30, 39].”
BackgroundResultSurvey on Diagnosing Retina Diseases in Optical Coherence Tomography Images Based on Deep Learning
Al-Amiry, S. H. (2024) · Journal of Al-Qadisiyah for Computer Science and Mathematics · doi:10.29304/jqcsm.2024.16.21568 · Cited by 2
“According to studies, DME affects over 7.5 million people 40 years of age or older [14].”
BackgroundInfluentialChambers, J. D., Beinfeld, M. T., Richardson, T., & Pangrace, M. (2025) · Journal of Managed Care & Specialty Pharmacy · doi:10.18553/jmcp.2025.24340 · Cited by 2
el-Khoury, S., ngo, C., Muraine, M., Abdelmassih, Y., & Portmann, A. (2025) · Journal of Clinical Medicine · doi:10.3390/jcm14113686 · Cited by 2
“The prevalence of DME varies depending on the study and population, with a recent U.S. study reporting a prevalence of 3.8% [2].”
InfluentialTawfek, A. Z., Elgharieb, M. E., Alnahass, H. S., Alnahrawy, O. M., & Gab-Alla, A. A. (2022) · Suez Canal University Medical Journal · doi:10.21608/scumj.2022.223250 · Cited by 2
Proportion of severity of retinal hard exudates and its association with systemic risk factors
Silpa, D., Sathar, A., & Thankappan, B. (2020) · International Journal of Advances in Medicine · doi:10.18203/2349-3933.ijam20205470 · Cited by 2
“01) similar to a study done in North India but several other studies showed no such correlation.(12,24,25) Our study also found a significant association between urine albumin excretion rate and retinal hard exudates in type 2 diabetic retinopathy patients similar to other studies.”
ResultXiao-yan, S., & Wei, W. (2022) · Journal of Ophthalmology · doi:10.1155/2022/2256779 · Cited by 2
Can the Future be Bright with Advances in Diabetic Eye Care?
Paul, S. K., Kim, C. U., Soliman, M. K., Sobol, W. M., Echegaray, J. J., & Kurup, S. K. (2022) · Endocrinology and Metabolism Clinics of North America · doi:10.1016/j.ecl.2022.06.004 · Cited by 2
Saad, M. A., Shehadeh, A., Hizzani, A., Alzibdeh, A. M., Alsubhi, A. A., Hamdan, D., Alkubati, E., Meqbil, J., Hamadneh, L., & Ababneh, O. H. (2022) · Middle East African Journal of Ophthalmology · doi:10.4103/meajo.meajo_135_22 · Cited by 2
Macular Thickness Fluctuations in Eyes With Diabetic Macular Edema Treated With Intravitreal Steroid
Roan, V. D., Kuo, B. L., Liu, B. J., Valentim, C. C. S., & Singh, R. P. (2023) · Ophthalmic surgery, lasers & imaging retina · doi:10.3928/23258160-20230615-02 · Cited by 2
AVANÇOS NA DIAGNÓSTICO E TRATAMENTO DE DOENÇAS OCULARES: PERSPECTIVAS ATUAIS NA OFTALMOLOGIA
Pinto, R. S., Cavalin, B., Fiterman, R. D., Silva, Y. M., Leme, J. V., Reche, N., Santos, A. R., Martins, F. M. D. S., de Franco, V. L. O., & de Oliveira, T. A. M. (2023) · Revista Ibero-Americana de Humanidades, Ciências e Educação · doi:10.51891/rease.v9i7.10702 · Cited by 2
Local ocular factors associated with the development of diabetic macular edema: an inter-eye study
Choi, J., Kim, S. J., Kang, S. W., Son, K. Y., & Hwang, S. (2023) · Scientific Reports · doi:10.1038/s41598-023-42038-9 · Cited by 2
“Nonetheless, the result of this study highlights that serum glucose level is an important systemic factor associated with the development of DME, consistent with findings from previous studies 1,7,8 .”
BackgroundResultDiabetic retinopathy screening and treatment
Nissen, T. P. H. (2023) · VBN Forskningsportal (Aalborg Universitet) · doi:10.54337/aau588589522 · Cited by 2
Tiosano, L., Ayalon, A., Banin, E., Averbukh, E., Jaouni, T., & Chowers, I. (2020) · Current Eye Research · doi:10.1080/02713683.2020.1812085 · Cited by 1
“Such data is important to facilitate evidence-base decision for the selection of the appropriate antiVEGF compound for fellow eyes in bilateral cases of DME.”
BackgroundInfluentialA study of therapeutic effects of 670 nm irradiation in different types of diabetic macular edema
Ramin, S., Ahadi, M., & Ebrahimi, A. (2021) · Biomedical Photonics · doi:10.24931/2413-9432-2020-9-4-15-22 · Cited by 1
Diabetic Macular Edema Treatment: Laser Photocoagulation Versus anti-VEGF Drugs
Elmadina, A. E. M. (2022) · Open Access Macedonian Journal of Medical Sciences · doi:10.3889/oamjms.2022.9561 · Cited by 1
“Diabetic macular edema (DME) is a common sign of diabetic retinopathy (DR), which is a leading cause of impaired vision in uncontrolled diabetic patients [1], [2], [3], [4].”
BackgroundTreatment Options for Diabetic Macular Edema
Bhatnagar, A., Ting, D. S. W., & Weng, C. Y. (2023) · International Ophthalmology Clinics · doi:10.1097/iio.0000000000000518 · Cited by 2
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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