0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Original Investigation |

Sex- and Age-Specific Prevalence and Incidence Rates of Sight-Threatening Diabetic Retinopathy in Taiwan

Jen-Chieh Lin, MD1,2; Wen-Yi Shau, MD, PhD3; Mei-Shu Lai, MD, PhD2
[+] Author Affiliations
1Department of Ophthalmology, Taipei City Hospital, Heping Fuyoy Branch, Taipei, Taiwan
2Graduate Institute of Epidemiology and Preventive Medicine, Department of Public Health, College of Public Health, National Taiwan University, Taipei, Taiwan
3Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
JAMA Ophthalmol. 2014;132(8):922-928. doi:10.1001/jamaophthalmol.2014.859.
Text Size: A A A
Published online

Importance  The prevalence of diabetic retinopathy (DR) is high in individuals with diabetes mellitus. Published estimates for sight-threatening DR (STDR) prevalence range widely. There is a need for precise contemporary estimates of the prevalence and incidence of STDR for providing optimal strategies of clinical management in Taiwan.

Objective  To determine the precise contemporary estimates of the prevalence and incidence of STDR in patients with type 2 diabetes mellitus in Taiwan.

Design, Setting, and Participants  Data were collected from a representative database, the Longitudinal Health Insurance Database 2005, from 2005 to 2011, on a total of 2926 incident cases of patients with STDR among 63 582 patients with type 2 diabetes. Sight-threatening DR was defined as clinically significant macular edema, severe nonproliferative DR, or proliferative DR according to the classification of the Early Treatment Diabetic Retinopathy Study research group. Sex-specific and age-adjusted incidence and prevalence rates of STDR were analyzed for patients with type 2 diabetes and STDR identified using International Classification of Diseases, Ninth Revision, Clinical Modification codes and procedure codes.

Main Outcomes and Measures  Procedure codes were used to determine the diagnosis of STDR.

Results  The number of incident cases of STDR increased in line with the increasing diabetic population during 2005-2011. Sex differences in the age-adjusted incidence rates were observed, showing a declining trend from 10.84 (95% CI, 10.69%-10.99%) to 6.00 (95% CI, 5.86%-6.14%) per 1000 person-years for women (P < .001) contrasting with an increasing trend in men, from 14.86 (95% CI, 14.71%-15.01%) to 21.89 (95% CI, 21.76%-22.02%) per 1000 person-years (P < .001). The age-adjusted prevalence rates of STDR were in decreasing trends for both sexes, with a mean of 2.75% for women and 2.87% for men. Apart from apparent sex differences in prevalence rates of STDR, increasing trends were observed among younger patients (aged <60 years).

Conclusions and Relevance  We found considerable variation in the incidence trends between sexes. Our findings provide evidence that the incident cases of STDR have increased among patients with type 2 diabetes, but the overall prevalence of STDR is in a declining trend in Taiwan, suggesting that decreased mortality rate, better diabetes management, and early detection of treatable DR might contribute to the prevalence patterns.

Figures in this Article

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

Figures

Place holder to copy figure label and caption
Figure 1.
Temporal Trends of Sight-Threatening Diabetic Retinopathy (STDR) During 2005-2011

A, Age-adjusted incidence per 1000 person-years. B, Prevalence rates for STDR by sex for the patients included in Longitudinal Health Insurance Database 2005 data in Taiwan. Significance for both trends, P < .001.

Graphic Jump Location
Place holder to copy figure label and caption
Figure 2.
Age- and Sex-Specific Incidence of Sight-Threatening Diabetic Retinopathy

The rates are presented as per 1000 person-years and stratified by sex and the age groups 20 to 39 years (A), 40 to 59 years (B), 60 to 79 years (C), and 80 years or older (D) for patients included in Longitudinal Health Insurance Database 2005 data during 2005-2011 in Taiwan.

Graphic Jump Location
Place holder to copy figure label and caption
Figure 3.
Age- and Sex-Specific Prevalence Rates of Sight-Threatening Diabetic Retinopathy

The rates are stratified by sex and the age groups for women (A) and men (B) included in Longitudinal Health Insurance Database 2005 data during 2005-2011 in Taiwan.

Graphic Jump Location

Tables

References

Correspondence

CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Submit a Comment

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Collections
PubMed Articles
Jobs
brightcove.createExperiences();