The Prevalence of Diabetic Retinopathy Among Adult Type1 Diabetic Persons in the United States

Objective

To estimate the US prevalence of diabetic retinopathy (DR) among personswith type 1 diabetes mellitus (DM).

Methods

Prevalence data from the New Jersey 725 and Wisconsin EpidemiologicStudy of Diabetic Retinopathy were used to estimate the prevalence of DR byage, gender, and race among persons 18 years and older having type 1 DM diagnosedbefore age 30 years. Severity of DR was determined via masked grading of 7-fieldstereoscopic fundus photographs. Any DR was defined as retinopathy severitylevel of 14 or more; and vision-threatening retinopathy, as retinopathy severitylevel of 50 or more, the presence of clinically significant macular edema,or both. The estimates of the prevalence of DR among persons with type 1 DMwere applied to the estimated number of persons with type 1 DM diagnosed beforeage 30 years in the 2000 US population to obtain prevalence estimates of DRdue to type 1 DM in the general population.

Results

Among 209 million Americans 18 years and older, an estimated 889 000have type 1 DM diagnosed before age 30 years. Among persons with type 1 DM,the crude prevalences of DR of any level (74.9% vs 82.3% in black and whitepersons, respectively) and of vision-threatening retinopathy (30.0% vs 32.2%,respectively) are high. The prevalence of DR due to type 1 DM diagnosed beforeage 30 years in the general population 18 years and older is estimated at767 000 persons having DR of any level (0.37%), and 376 000 personshaving vision-threatening retinopathy (0.18%).

Conclusion

Retinopathy due to type 1 DM is an important public health problem inthe United States, affecting 1 per 300 persons 18 years and older, and 1 per600 persons with advanced, vision-threatening retinopathy.