ABSTRACT
Purpose: Diabetic retinopathy is a leading cause of blindness worldwide. The last 3 decades have seen major improvements in glycemic and blood pressure control as well as the introduction of national screening programs, and we sought to determine if rates of proliferative diabetic retinopathy have changed as a result.
Methods: We conducted a systematic review to determine whether the incidence and progression rates of proliferative diabetic retinopathy and sight-threatening retinopathy have changed, focusing on large population-based studies with objective assessment of diabetic retinopathy.
Results: Comparisons across different studies is problematic due to different baseline retinopathy severity, different reported outcomes and different follow-up periods, but within these constraints certain trends could be identified. This review provides evidence that the incidence and progression of these conditions has reduced by approximately 2–3 fold over the last 3 decades.
Conclusion: These results have implications for current diabetic retinopathy screening guidelines and has identified future areas where research could be improved.
Declaration of interest
The authors report no conflicts of interest. The authors alone are responsible for the writing and content of this article.
Funding
National Health and Medical Research Council Early Career Fellowship Grant APP1073530 to Gerald Liew.