Changes observed in diabetic retinopathy: eight-year follow-up of a Spanish population

BACKGROUND/AIMS To determine the changes in the incidence of diabetic retinopathy (DR), diabetic macular oedema (DMO) and their risk factors in a population-based study of patients with diabetes mellitus (DM) referred to our 16 Primary Health Care Areas (HCAs). METHODS Prospective population-based study of a total of 15 396 Caucasian patients with DM, who represent 86.53% of the total patients with DM in our HCAs, were studied over an 8-year follow-up period. All patients were screened with a mean follow-up of 3.18±1.11 times for each patient over the 8 years. RESULTS The yearly mean value of any DR was 8.37±2.19% (8.09%-8.99%); of advanced DR yearly mean value of 0.46±0.22% (0.03-0.78); and of DMO a yearly mean value of 2.19±0.18% (2%-2.49%). A clear increase was observed in the last 3 years, any DR increased from 8.09% in 2007 to 8.99% in 2014, and DMO from 2% in 2007 to 2.49% in 2014. These increases were more evident in some age groups. For patients with any DR aged 41-50 and 51-60 and for patients with advanced DR aged 41-50, 51-60 and 61-70, the increase was more marked, related to an increase in HbA1c values or to patients treated with insulin. CONCLUSIONS An increase in the incidence of DR and DMO was observed, especially in the younger patients aged between 31 and 70 years. This is linked to bad metabolic control of DM. Our results suggest a greater number of ocular complications in the near future, such as neovascular glaucoma, if these current findings are not addressed.