Diabetic retinopathy : facts and resources

Diabetic retinopathy (DR) is the most frequent ocular complication in patients with diabetes and the main cause of blindness in the working age population in industrialized and developing countries. The most important risk factors that contribute to the pathogenesis of DR are chronic hyperglycaemia, hyperlipidemia and hypertension. Epidemiologic data show that each year 12 percent of new cases of legal blindness are attributed to diabetic retinopathy (DR) and that its prevalence increases with both increased duration of diabetes and the age of patients. Of insulin‐dependent patients with diabetes for 30 or more years, 12% are blind. Diabetic macular edema (DME) is a frequent manifestation of DR and the leading cause of legal blindness in patients with type 2 diabetes. Over a 10‐year period, non clinically significant DME and clinically significant DME will respectively develop in 14% and 10% of known diabetic patients. Approximately half of patients with DME will loose two or more lines of visual acuity within 2 years. Overall social costs (expenditures and lost productivity) caused by DR are about $174 billion in the USA. Approximately 20% of health care expenditures for persons with DM (50% with DM as a co‐morbidity), 10% of expenditures for complications of DM and 15% of expenditures for health care for DM are ophthalmic. Therefore, DR accounts for significant economic costs that can be reduced with early diagnosis, achieved with screening methods. Screening of DR allows for timely treatment, vision preservation and consequent saving costs. Implementation of screening systems in different environments worldwide is the first necessary step in order to prevent blindness caused by diabetes mellitus.