Skip to main content

Advertisement

SpringerLink
Log in

The prevalence of retinopathy among type 2 diabetic patients in Iran: A systematic review and meta-analysis

  • Published:
Reviews in Endocrine and Metabolic Disorders Aims and scope Submit manuscript

Abstract

Diabetic retinopathy is one of the most major causes of blindness and disability in diabetic patients and imposes very high cost on Health Care System. Studies conducted in the country showed different and inconsistent prevalence of the disease. The study aims to determine the overall prevalence of retinopathy in patients with type 2 diabetes in Iran through a systematic review and meta-analysis. The present study was conducted via meta-analysis method during March, 2000 to October, 2018. The articles related to the subject under study were obtained from Magiran, SID, Medline (PubMed), Science Direct, Scopus and Google Scholar databases. I2 index was used to examine the heterogeneity of articles studied; and the data was analyzed by Comprehensive Meta-Analysis Software. Through the study of 34 articles and 17,079 individuals with age range of 5–83, the overall prevalence of retinopathy for type 2 diabetic patients in Iran and on the basis of meta-analysis, was obtained that was 37.8% (32.84–43%, 95% confidence interval); the highest prevalence of retinopathy for type 2 diabetic patients was in Tehran province with 78% (68.8–85.1%, 95% confidence interval) in 2006 and the lowest prevalence of retinopathy for type 2 diabetic patients was in Isfahan province with 9% (7.1–11.4, 95% confidence interval) in 2006; furthermore, the prevalence of retinopathy for type 2 diabetic patients in Iran increases with increased sample size that it was statistically significant (P < 0.05). Regarding the high prevalence of retinopathy for type 2 diabetic patients in the country, it is essential that health policy makers take effective measures to reduce the disease incidence in diabetic patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. Mohammadi M, Mirzaei M. Population attributable fraction of cardiovascular disease associated with diabetes mellitus in Yazd city. J Shahid Sadoughi Univ Med Sci. 2017;25(8):603–11.

    Google Scholar 

  2. Mohammadi M, Mirzaei M, Karami M. Potential impact fraction of ischemic heart disease associated with diabetes mellitus in Yazd- Iran. Iranian Journal of Epidemiology. 2018;13(4):299–307.

    Google Scholar 

  3. Fong DS, Aiello LP, Ferris FL, Klein R. Diabeticretinopathy. Diabetes Care. 2004;27:2540–53.

    Article  PubMed  Google Scholar 

  4. Powers A. Human diabetes mellitus. In: Kasper B, Fauci A, Longo D, editors. Harrison’s Principle of internal medicine. 16th ed. USA: McGrawhil; 2005. p. 16.

    Google Scholar 

  5. Hadaegh F, Khalili D, Fahimfar N, Tohid M, Eskandari F, Azizi F. Glucose intolerance and risk of cardiovascular disease in Iranian men and women: results of the 7.6-year follow-upof the Tehran lipid and glucose study (TLGS). J Endocrinol Investig. 2009;32:724–30.

    Article  CAS  Google Scholar 

  6. Heshmati H, Behnampour N, KHorasani F, Moqadam Z. The prevalence of chronic complications of diabetes and its risk factors in patients with type II diabetes mellitus city center Fereidoon'kenar. J Neyshabur Univ Med Sci. 2014;1(1):36–42.

  7. Frank R. Diabetic retinopathy. N Engl J Med. 2004;350(1):48–58.

    Article  CAS  PubMed  Google Scholar 

  8. Rotimi C, Daneil H, Zhou J, Obisean A, Chen Y, Amoah A, et al. Prevalence and determinants diabetics retinopathy and cataracts in west African type 2 diabetes patients. Ethn Dis. 2003;13(2):110–7.

    Google Scholar 

  9. McKay R, McCarty CA, Taylor HR. Diabetic retinopathy in Victoria, Australia: the visual impairment project. Br J Ophthalmol. 2000;84:865–70.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Klein R, Klein BE, Moss SE, Davis MD, De Mets DL. The wisconsin epidemiologic study of diabetic retinopathy. II. Prevalence and risk of diabetic retinopathy when age at diagnosis is less than 30 years. Arch Ophthalmol. 1984;102(4):520–6.

  11. Henricsson M, Nyström L, Blohmé G, Ostman J, Kullberg C, Svensson M, et al. The incidence of retinopathy 10 years after diagnosis in young adult people with diabetes: results from the nationwide population-based Diabetes Incidence Study in Sweden (DISS). Diabetes Care. 2003;26(2):349–54.

  12. Kohner EM, Aldington SJ, Stratton IM, Manley SE, Holman RR, Matthews DR, et al. United Kingdom Prospective Diabetes Study, 30: diabetic retinopathy at diagnosis of non-insulin-dependent diabetes mellitus and associated risk factors. Arch Ophthalmol. 2000;116:297–303.

    Article  Google Scholar 

  13. Manaviat MR, Afkhami Ardakani M. Evaluation of prevalence of retinopathy in type 2 diabetic patients referred to Yazd Diabetes Research Center. Journal of Shahid Sadoughi University of Medical Sciences. 2002;10(4):41–6.

    Google Scholar 

  14. Malekmadani MH, Lashay A, Behjati M, Ganji R. Frequency and severity of diabetic retinopathy in non-ocular diabetic complications. Tehran Univ Med J. 2007;65(7):58–63.

    Google Scholar 

  15. Naseripour M, Ansari MR, Shikhi F, Daneshgar F, Omidian J, Ghaderi E. The prevalence of retinopathy and its risk factors in diabetic patients referring to Kermanshah Diabetes Research Center. Journal of Kermanshah University of Medical Sciences. 2005;9(4):44–51.

    Google Scholar 

  16. Aghadoost D, Sadr SF. Prevalence and risk factors for diabetic retinopathy in diabetic patients of Kashan diabetic center in 2002-2003. Feyz. 2005;9(1):62–5.

    Google Scholar 

  17. Foroutan A, ASghari A, Afsar N, Vadipour A, Joushghani M, Nilforoushan N, et al. Evaluation of correlation between severity of dry eye syndrome and retinopathy in patients with diabetes mellitus. Armaghane danesh. 2007;11(4):19–28.

    Google Scholar 

  18. Akbarzadeh S, Manikashani K. The prevalence of diabetic retinopathy and its related factors in diabetic patients. Journal of Tabriz University of Medical Sciences. 2006;28(2):15–8.

    Google Scholar 

  19. Eslami F, Ghasemi Basir HR. The prevalence of diabetic retnopathy and its relationship with microalbuminuria in type 2 diabetic patients at diabetes Center of Hamadan city. Scientific Journal of Hamadan University of Medical Sciences. 2016;22(4):286–92.

    Google Scholar 

  20. Shafiepour L, Ahmadzadeh A, Shafiepour V, Khalilian A. The prevalence of diabetic retinopathy and risk factors among diabetic patients attending to Imam Khomeini hospital in Sari. J Mazandaran Univ Med Sci. 2006;16(55):125–30.

    Google Scholar 

  21. Ramezani M. Karimi zarchi AA. Prevalence of retinopathy and its effective factors in patients admitted to Baqiyatallah Azam Hospital in Tehran. Yafte. 2005;7(1):29–36.

    Google Scholar 

  22. Safaei H, Amini M, Behroz J, Teimori A. Retinopathy in newly diagnosed type 2 diabetic patients in Isfahan, prevalence and risk factors. Iranian Journal of Diabetes and Metabolism. 2006;5(3):236–43.

    Google Scholar 

  23. Askarishahi M, Hajizadeh I, Afkhamiardakani M. Factors affecting retinopathy in patients with type 2 diabetes by analyzing the current status data. Tehran Univ Med J. 2011;68(11):674–80.

    Google Scholar 

  24. Hosseini R, Davoodabadi Farahani A. Prevalence and risk factors of diabetic retinopathy in patients referred to diabetes Clinic of Kamkar Hospital in Qom. Qom Univ Med Sci J. 2012;5(4):40–6.

    Google Scholar 

  25. Mazarei M. Risk factors of diabetic retinopathy in patients referred to Bouali eye center. J Qazvin Univ Med Sci. 2005;9(3):34–9.

    Google Scholar 

  26. Hosseini SM, Tazhibi M, Amini M, Zaree A, Jahani HH. Using classification tree for prediction of diabetic retinopathy on type II diabetes. Isfahan Univ Med Sci J. 2009;28(104):15–24.

    Google Scholar 

  27. Abbasian M, Delvarianzadeh M. Evaluation of complications of diabetes in patients referring to Shahrood diabetes clinic. Journal of Knowledge & Health. 2007;2(4):17–21.

    Google Scholar 

  28. Bonakdaran S, Yaghoubi MA. Is insulin resistance a contributor risk factor for diabetic retinopathy in type 2 diabetes? Iranian Journal of Endocrinology and Metabolism. 2014;15(5):450–5.

    Google Scholar 

  29. Manaviat M, Afkhami-Ardakani M, Rashidi M. Study of four year incidence rate of diabetic retinopathy and its associated factors in type ii Diabetese patients. JSSU. 2006;14(3):11–9.

    Google Scholar 

  30. Kohian H, Sohrabi MB, Zolfaghari P, Shaker S, Farsad R, Yahyaei E. Prevalence and related factors related to diabetic retinopathy in Shahrood. Journal of Knowledge & Health. 2013;7(4):179–84.

    Google Scholar 

  31. Rafati N, Dehghan M, Javadi M, Souri H, Zaeri F, Gooya M, et al. The prevalence of diabetic retinopathy in Tehran Province. Bina J Ophthalmol. 2008;13(2):166–75.

    Google Scholar 

  32. Yaghobi MA, Bonakdaran SH, Shoaibi N, Nabavi A. The relationship between hsCRP level and the severity of diabetic retinopathy. Medical Journal of Mashhad University of Medical Sciences. 2014;57(6):756–61.

    Google Scholar 

  33. Bonakdaran S, Osat LA. Relation between magnesium retinopathy levels in type II diabetes. Medical Journal of Mashhad University of Medical Sciences. 2015;58(1):42–8.

    Google Scholar 

  34. Bonakdaran SH, Shoeaibi N. Is there a relation between plasminogen activating inhibitor factor and diabetic retinopathy in diabetic patients? Medical Journal of Mashhad University of Medical Sciences. 2016;58(10):603–10.

    Google Scholar 

  35. Taher khani M, Safi M. Evaluation of correlation between microvascular complications and coronary disease in patients with type 2 diabetes mellitus. Research in Medicine. 2014;38(3):167–72.

  36. Dehghan M, Katibeh M, Ahmadieh H, Ramezani A, Moradian S, Noorinia R, et al. Prevalence and risk factors of diabetic retinopathy in Yazd Province. Bina J Ophthalmol. 2013;18(4):375–91.

    Google Scholar 

  37. Shojae MR. Diabetic retinopathy in patients referred to Yazd Diabetes Research Center. JSSU. 2000;8(3):10–7.

    Google Scholar 

  38. Abdullahi A, Ardashirlarijani MB, Zaree R. The prevalence of diabetic retinopathy and its related factors in patients referred to Shariati Hospital in Tehran in 1998. Iranian Journal of Ophthalmology. 2000;12(3):76–82.

    Google Scholar 

  39. Heydari B, Yaghoubi G, Yaghoubi MA, Miri MR. Prevalence of diabetic retinopathy in Tehran province: a population-based study. Eur J Ophthalmol. 2012;22(3):393–7.

    Article  PubMed  Google Scholar 

  40. Dehghan MH, Katibeh M, Ahmadieh H, Nourinia R, Yaseri M. Prevalence and risk factors for diabetic retinopathy in the 40 to 80 year-old population in Yazd, Iran: the Yazd eye study. J Diabetes. 2015;7(1):139–41.

    Article  PubMed  Google Scholar 

  41. Javadi MA, Katibeh M, Rafati N, Dehghan MH, Zayeri F, Yaseri M, et al. Prevalence of diabetic retinopathy in Tehran province: a population-based study. BMC Ophthalmol. 2009;9:12.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  42. Abdollahi A, Daneshpazhooh M, Amirchaghmaghi E, Sheikhi S, Eshrati B, Bastanhagh MH. Dermopathy and retinopathy in diabetes: is there an association? Dermatology. 2007;214(2):133–6.

    Article  PubMed  Google Scholar 

  43. Manaviat MR, Afkhami M, Shoja MR. Retinopathy and microalbuminuria in type II diabetic patients. BMC Ophthalmol. 2004;4:9.

    Article  PubMed  PubMed Central  Google Scholar 

  44. Janghorbani M, Amini M, Ghanbari H, Safaiee H. Incidence of and risk factors for diabetic retinopathy in Isfahan, Iran. Ophthalmic Epidemiol. 2003;10(2):81–95.

    Article  PubMed  Google Scholar 

  45. Shoeibi N, Bonakdaran S. Is there any correlation between diabetic retinopathy and risk of cardiovascular disease? Curr Diabetes Rev. 2017;13(1):81–6.

    Article  PubMed  Google Scholar 

  46. Valizadeh R, Moosazadeh M, Bahaadini K, Vali L, Lashkari T, Amiresmaili M. Determining the prevalence of retinopathy and its related factors among patients with type 2 diabetes in Kerman, Iran. Osong Public Health Res Perspect. 2016;7(5):296–300.

  47. Jenneld B, Algvere P. Relationship of duration and onset of diabetes to prevalence of diabetic retinopathy. Amj Opthalmol. 2002;102(4):431–7.

    Article  Google Scholar 

  48. Jaross N, Rayan P, Newland H. Prevalence of diabetic retinopathy in an aboriginal Australian population. Clin Exp Ophthalmol. 2003;31(1):32–9.

    Article  PubMed  Google Scholar 

  49. Carlos F, Ramírez-Gámez J, Dueñas H, Galindo-Suárez RM, Ramos E. Economic evaluation of duloxetine as a first-line treatment for painful diabetic peripheral neuropathy in Mexico. J Med Econ. 2012;15(2):233–44.

    Article  PubMed  Google Scholar 

  50. Keen H, Lee ET, Russell D, Miki E, Bennett PH, Lu M. The appearance of retinopathy and progressionto proliferative retinopathy: the WHO multinational study of vascular disease in diabetes. Diabetologia. 2001;44(2):S22–30.

    Article  CAS  PubMed  Google Scholar 

  51. Kohner EM, Stratton IM, Aldington SJ, Holman RR, Matthews DR; UK Prospective Diabetes Study (IKPDS) Group. Relationship between the severity of retinopathy and progression to photocoagulation in patients with Type 2 diabetes mellitus in the UKPDS (UKPDS 52). Diabet Med. 2001;18(3):178–84.

  52. Marshall G, Garg SK, Jackson WE, Holmes DL, Chase HP. Factors influencing the onset and progression of diabetic retinopathy in subjects with insulin-dependent diabetes mellitus. Ophthalmology. 1993;100(8):1133–9.

    Article  CAS  PubMed  Google Scholar 

  53. Azpiroz F, Malagelada C. Diabetic neuropathy in the gut: pathogenesis and diagnosis. Diabetologia. 2016;59(3):404–8.

    Article  CAS  PubMed  Google Scholar 

  54. Voutilainen-Kaunisto RM, Teräsvirta ME, Uusitupa MI, Niskanen LK. Occurrence and predictors of retinopathy and visual acuity in Type 2 diabetic patients and control subjects. 10-year follow-up from the diagnosis. J Diabetes Complicat. 2001;15(1):24–33.

    Article  CAS  PubMed  Google Scholar 

  55. Khandekar R, Al Lawatii J, Mohammed AJ, Al Raisi A. Diabetic retinopathy in Oman: a hospital based study. Br J Ophthalmol. 2003;87(9):1061–4.

  56. Katulanda P, Ranasinghe P, Jayawardena R. Prevalence of retinopathy among adults with self-reported diabetes mellitus: the Sri Lanka diabetes and cardiovascular study. BMC Ophthalmol. 2014;14:100.

    Article  PubMed  PubMed Central  Google Scholar 

  57. Rahman S, Nawaz R, Khan GJ, Aamir AH. Frequency of diabetic retinopathy in hypertensive diabetic patients in a tertiary care hospital of Peshawar, Pakistan. J Ayub Med Coll Abbottabad. 2011;23(2):133–5.

    PubMed  Google Scholar 

  58. Chen MS, Kao CS, Chang CJ, Wu TJ, Fu CC, Chen CJ, et al. Prevalence and risk factors of diabetic retinopathy among noninsulin-dependent diabetic subjects. Am J Ophthalmol. 1992;114(6):723–30.

    Article  CAS  PubMed  Google Scholar 

  59. el Haddad OA, Saad MK. Prevalence and risk factors for diabetic retinopathy among Omani diabetics. Br J Ophthalmol. 1998;82(8):901–6.

  60. Tapp RJ, Shaw JE, Harper CA, de Courten MP, Balkau B, McCarty DJ, et al. The prevalence of and factors associated with diabetic retinopathy in the Australian population. Diabetes Care. 2003;26(6):1731–7.

    Article  PubMed  Google Scholar 

  61. Remachandran A, Snehalatha C, Vijay V. Diabetic retinopathy at the time of diagnosis of NIDDM in south Indian subject. Diabetes Resclin Pract. 2001;32:1114.

    Google Scholar 

  62. Grammatiki M, Rapti E, Karras S, Ajjan RA, Kotsa K. Vitamin D and diabetes mellitus: causal or casual association? Rev Endocr Metab Disord. 2017;18(2):227–41.

    Article  CAS  PubMed  Google Scholar 

  63. Škrha J, Šoupal J, Škrha J Jr, Prázný M. Glucose variability, HbA1c and microvascular complications. Rev Endocr Metab Disord. 2016;17(1):103–10.

    Article  PubMed  CAS  Google Scholar 

  64. Rotimi C, Daniel H, Zhou J, Obisesan A, Chen G, Chen Y, et al. Prevalence and determinants of diabetic retinopathy and cataracts in West African type 2 diabetes patients. Ethn Dis. 2003;13(2):S110–7.

    PubMed  Google Scholar 

  65. Dil A, Caliskan D, Ocaktan E. The prevalence of blindness and low vision in older onset diabetes mellitus and associated factors: a community-based study. Eur J Ophthalmol. 2004;14(4):298–305.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Nursing, School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran

    Masoud Mohammadi, Ali Akbar Vaisi Raiegani, Rostam Jalali, Akram Ghobadi & Nader Salari

Authors
  1. Masoud Mohammadi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ali Akbar Vaisi Raiegani
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Rostam Jalali
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Akram Ghobadi
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Nader Salari
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Masoud Mohammadi.

Ethics declarations

Conflict of interest

The authors have no conflicts of interest to declare.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Mohammadi, M., Raiegani, A.A.V., Jalali, R. et al. The prevalence of retinopathy among type 2 diabetic patients in Iran: A systematic review and meta-analysis. Rev Endocr Metab Disord 20, 79–88 (2019). https://doi.org/10.1007/s11154-019-09490-3

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11154-019-09490-3

Keywords

Search

Navigation