Global estimates on the number of people blind or visually impaired by diabetic retinopathy: a meta-analysis from 2000 to 2020
Authors:   Vision Loss Expert Group of the Global Burden of Disease Study, Curran Katie , Peto Tunde , Jonas Jost B. , Friedman David , Kim Judy E. , Leasher Janet , Tapply Ian , Fernandes Arthur G. , Cicinelli Maria Vittoria , Arrigo Alessandro , Leveziel Nicolas , Resnikoff Serge , Taylor Hugh R. , Sedighi Tabassom , Flaxman Seth , Bikbov Mukkharram M. , Braithwaite Tasanee , Bron Alain , Cheng Ching-Yu , Del Monte Monte A. , Ehrlich Joshua R. , Furtado João M. , Gazzard Gus , Hartnett M. Elizabeth , Kahloun Rim , Kempen John H. , Khairallah Moncef , Khanna Rohit C. , Lansingh Van Charles , Naidoo Kovin S. , Nangia Vinay , Nowak Michal , Pesudovs Konrad , Ramulu Pradeep , Topouzis Fotis , Tsilimbaris Mitiadis , Wang Ya Xing , Wang Ningli , Bourne Rupert R. A. ,   the GBD 2019 Blindness and Vision Impairment Collaborators, Curran Katie , Peto Tunde , Bourne Rupert , Leasher Janet L. , Jonas Jost B. , Friedman David S. , Kim Judy E. , Fernandes Arthur G. , Ahinkorah Bright Opoku , Ahmadieh Hamid , Ahmed Ayman , Alfaar Ahmad Samir , Almidani Louay , Amu Hubert , Androudi Sofia , Arabloo Jalal , Aravkin Aleksandr Y. , Asemu Mulu Tiruneh , Azzam Ahmed Y. , Baghcheghi Nayereh , Bailey Freddie , Baran Mehmet Firat , Bardhan Mainak , Bärnighausen Till Winfried , Barrow Amadou , Bhardwaj Pankaj , Bikbov Mukharram , Braithwaite Tasanee , Briant Paul Svitil , Burkart Katrin , Cámera Luis Alberto , Coberly Kaleb , Dadras Omid , Dai Xiaochen , Dehghan Amin , Demessa Berecha Hundessa , Diress Mengistie , Do Thanh Chi , Do Thao Huynh Phuong , Dokova Klara Georgieva , Duncan Bruce B. , Ekholuenetale Michael , Elhadi Muhammed , Emamian Mohammad Hassan , Emamverdi Mehdi , Farrokhpour Hossein , Fatehizadeh Ali , Desideri Lorenzo Ferro , Furtado João M. , Gebrehiwot Mesfin , Ghassemi Fariba , Gudeta Mesay Dechasa , Gupta Sapna , Gupta Veer Bala , Gupta Vivek Kumar , Hammond Billy Randall , Harorani Mehdi , Hasani Hamidreza , Heidari Golnaz , Hosseinzadeh Mehdi , Huang John J. , Islam Sheikh Mohammed Shariful , Javadi Nilofer , Jimenez-Corona Aida , Jokar Mohammad , Joshua Charity Ehimwenma , Kadashetti Vidya , Kandel Himal , Kasraei Hengameh , Kaur Rimple Jeet , Khanal Sudarshan , Khorrami Zahra , Koohestani Hamid Reza , Krishan Kewal , Lim Stephen S. , El Razek Mohammed Magdy Abd , Mansouri Vahid , Maugeri Andrea , Mestrovic Tomislav , Misganaw Awoke , Mokdad Ali H. , Momeni-Moghaddam Hamed , Momtazmanesh Sara , Murray Christopher J. L. , Negash Hadush , Osuagwu Uchechukwu Levi , Pardhan Shahina , Patel Jay , Pawar Shrikant , Petcu Ionela-Roxana , Pham Hoang Tran , Pourazizi Mohsen , Qattea Ibrahim , Rahman Mosiur , Saeed Umar , Sahebkar Amirhossein , Salehi Mohammad Amin , Shayan Maryam , Shittu Aminu , Steinmetz Jaimie D. , Tan Yao , Topouzis Fotis , Tsatsakis Aristidis , Umair Muhammad , Vos Theo , Xiao Hong , You Yuyi , Zastrozhin Mikhail Sergeevich , Zhang Zhi-Jiang , Zheng Peng 
Published: June 2024

Abstract
Objectives
To estimate global and regional trends from 2000 to 2020 of the number of persons visually impaired by diabetic retinopathy and their proportion of the total number of vision-impaired individuals.

Methods
Data from population-based studies on eye diseases between 1980 to 2018 were compiled. Meta-regression models were performed to estimate the prevalence of blindness (presenting visual acuity <3/60) and moderate or severe vision impairment (MSVI; <6/18 to ≥3/60) attributed to DR. The estimates, with 95% uncertainty intervals [UIs], were stratified by age, sex, year, and region.

Results
In 2020, 1.07 million (95% UI: 0.76, 1.51) people were blind due to DR, with nearly 3.28 million (95% UI: 2.41, 4.34) experiencing MSVI. The GBD super-regions with the highest percentage of all DR-related blindness and MSVI were Latin America and the Caribbean (6.95% [95% UI: 5.08, 9.51]) and North Africa and the Middle East (2.12% [95% UI: 1.55, 2.79]), respectively. Between 2000 and 2020, changes in DR-related blindness and MSVI were greater among females than males, predominantly in the super-regions of South Asia (blindness) and Southeast Asia, East Asia, and Oceania (MSVI).

Conclusions
Given the rapid global rise in diabetes and increased life expectancy, DR is anticipated to persist as a significant public health challenge. The findings emphasise the need for gender-specific interventions and region-specific DR healthcare policies to mitigate disparities and prevent avoidable blindness. This study contributes to the expanding body of literature on the burden of DR, highlighting the need for increased global attention and investment in this research area.