Diabetic Retinopathy

Change in Diabetic Retinopathy Prevalence, Age 40 and Older

Diabetic retinopathy is a common complication of diabetes. It affects the tiny blood vessels of the retina. Retinal blood vessels can break down, leak or become blocked— affecting and impairing vision over time. In some people with diabetic retinopathy, serious damage to the eye can occur when abnormal new blood vessels grow on the surface of the retina.

Diabetic retinopathy can affect almost anyone with diabetes. The U.S. Centers for Disease Control and Prevention (CDC) estimate that 18.8 million Americans have diagnosed diabetes, while an additional 7.0 million have diabetes that has not been diagnosed.

In general, the longer someone has diabetes, the greater the risk of developing diabetic retinopathy. Eventually, almost everyone with juvenile-onset diabetes will develop some signs of diabetic retinopathy. Those who acquire diabetes later in life are also at risk of diabetic retinopathy, although they are somewhat less likely to develop advanced diabetic retinopathy.

Diabetes also increases the risk of other eye diseases such as cataract and glaucoma. Because of its dangers to good vision, people with diabetes are urged to seek annual dilated eye exams.

Research suggests that the risk of diabetic retinopathy can be reduced through careful control of blood sugar. People with diabetes are also encouraged to control their blood pressure.

Laser treatment, called photocoagulation, has been shown to reduce the risk of sight loss in advanced cases of diabetic retinopathy. Focal photocoagulation can be used to destroy leaking blood vessels. Scatter photocoagulation, where a large number of spots are destroyed by the laser, is used to control the growth of abnormal blood vessels. In some cases vitrectomy, a surgical procedure to remove clouded fluid and gel from inside the eye, can help.

The prevalence estimates for cases of diabetic retinopathy include those with mild or worse retinopathy (grade 14 or higher based on fundus photographs), including definite non-proliferative retinopathy (e.g., microaneurysms, blot hemorrhages), macular edema or proliferative changes.  

Diabetic retinopathy affects nearly 7.7 million people. In the decade since the 2002 edition of this report, the prevalence of diabetic retinopathy among Americans age 40 and older has increased significantly. Due to a lack of information about diabetic retinopathy in other races, the prevalence estimates for "other" races are the arithmetic average of those for Whites, Blacks and Hispanics.