Unravelling epidemiological trends and risk disparities in diabetic retinopathy

• Author Details:   
• Muhammad Zulfiqah Sadikan
• Nurul Alimah Abdul Nasir ^*

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Diabetic retinopathy (DR) remains a leading cause of blindness worldwide, driven by the epidemic rise in diabetes mellitus. The epidemiology of DR is reflected as global trends in lifestyle, urbanization, and health disparities, with variation between populations and regions. Socioeconomic differences contribute to the burden of DR, making imperative need for integrated public health interventions. The pathogenesis of DR is multifactorial and is characterized by common risk factors including hyperglycaemia, diabetes duration, hypertension, dyslipidaemia, smoking, genetic predisposition, obesity, albuminuria, and pregnancy. Of these, control of glycemia plays an important role, with elevated levels of glycated haemoglobin (HbA1c) imparting a high risk for the development and onset of DR. Also, longer duration of diabetes has a very high correlation with greater prevalence of DR, affecting 100% of type 1 DM patients at 30 years and 90% of type 2 DM patients in the same duration. The disease is manifested as non-proliferative (NPDR) or proliferative (PDR) DR, by the presence of neovascularization. Diabetic macular oedema (DME) can occur at any time and results in serious vision loss. This review explores the multifaceted epidemiology and determinants of risk of DR, synthesizing current evidence to inform opportunities for tailored interventions. It is crucial to elucidate the multifactorial interaction of metabolic, vascular, genetic, and environmental determinants, to tailor prevention efforts, early detection, and effective management approaches. Policy and clinical practice based on evidence for these determinants are key to preventing the public health burden of DR and preserving vision in affected individuals.