Study Finds Significantly More Adults Living with Diabetic Retinopathy in the US than Estimated

A study published in JAMA Ophthalmology provides updated estimates of the prevalence of diabetic retinopathy (DR) and vision-threatening diabetic retinopathy (VTDR) in the United States in 2021. The study estimates that 9.60 million people in the US, accounting for 26.43% of those with diabetes, had DR in 2021. Additionally, 1.84 million people, or 5.06% of those with diabetes, had VTDR. There was significant variation in prevalence across states, and the number of people living with diabetes-related eye disease has increased since the last estimation in 2004. The study highlights the high prevalence of diabetes-related eye disease in the US and predicts that it may continue to grow in the future due to the increasing burden of diabetes among both youth and adults. The updated estimates can be useful for allocating public health resources and implementing interventions in communities and populations at higher risk.

From Prevent Blindness:

Diabetic retinopathy occurs when small blood vessels leak and bleed in the retina. The retina is the layer of cells lining the back wall inside the eye that senses light and sends signals to the brain for vision. Early detection and treatment can reduce the risk of vision loss from this potentially blinding eye disease.

The ‘Prevalence of Diabetic Retinopathy in the US in 2021’ study was authored by researchers from the Centers for Disease Control and Prevention’s (CDC) Vision Health Initiative, NORC at the University of Chicago (NORC), and the Institute for Health Metrics and Evaluation (IHME) at the University of Washington (Seattle), with support from Prevent Blindness.

“The national increase of diabetes over the last two decades has likely impacted the number of people living with serious complications like diabetic retinopathy,” said CDC epidemiologist Elizabeth Lundeen, PhD, MPH. “This study provides new state and county level prevalence estimates that the health care and public health communities can use to inform screening and early interventions for optimal vision health.”

Abraham Flaxman, PhD, added: “In this work, we brought together data from all the relevant sources in the CDC’s Vision and Eye Health Surveillance System to triangulate between multiple measurements and make estimates that no single source could provide alone.”

Additional key findings from the study include:

• Approximately 1 in 4 Americans ages 40 and older with diabetes have DR.
• These new estimates include the prevalence of DR and VTDR in people younger than age 40 years. Past prevalence estimates were only for the US population aged 40 and older.
• VTDR prevalence rates are higher for Black (8.7 percent) and Hispanic (7.1 percent) individuals than White individuals (3.6 percent). Thus, a higher percentage of Black and Hispanic individuals with diabetes are at risk for vision loss compared to their White counterparts.
• The prevalence of both DR and VTDR varied widely by U.S. state and county. After standardizing by age, sex/gender, and race/ethnicity, rates of DR among persons with diabetes ranged from a low of 21.2 percent in Nevada to a high of 34.2 percent in Hawaii.
• Prevalence of DR and VTDR among people with diabetes increased substantially with age but then decreased in the older age groups, likely because DR and VTDR are markers for more severe diabetes, which can lead to early mortality.