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“Prevalence of diabetic retinopathy in Eastern Mediterranean Region (EMR): A systematic review and meta-analysis”
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  • Alireza Heiran,
  • Seyede Pegah Azarchehry,
  • Saeid Dehghan Khalili,
  • Mehrded Afarid,
  • Sonia Shaabani,
  • Alireza Mirahmadizadeh
Alireza Heiran
Shiraz Medical School
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Seyede Pegah Azarchehry
Tarbiat Modares University
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Saeid Dehghan Khalili
Shiraz University
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Mehrded Afarid
Shiraz Medical School
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Sonia Shaabani
Shiraz Medical School
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Alireza Mirahmadizadeh
Shiraz Medical School

Corresponding Author:[email protected]

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Abstract

Objectives: Diabetic Mellitus is a global epidemic, exerting a substantial burden on health care services. This high prevalence of diabetes leads to an increase in diabetic complications, and diabetic retinopathy is a leading cause of blindness and vision disability. Individual studies on the prevalence of diabetic retinopathy in EMR showed the high prevalence of diabetic retinopathy in EMR. Therefore, we conducted a systematic review and meta-analysis of relevant studies to estimate diabetic retinopathy in EMR. Method: We searched for the relevant keywords in the title and abstract of Medline/PubMed, Scopus, Embase, and Web of knowledge, as well as Google Scholar and manual search to identify the published target studies from Jan 1st, 2000 to December 13, 2019. The two-step screening was carried out by two independent researchers and relevant data were extracted. Estimation of summary proportions, subgroup analysis, meta-regressions, and publication bias assessment was performed. Results: Amongst 4,139 identified citations, 109 articles were entered into a meta-analysis, involving 280,566 patients. We found that the prevalence of diabetic retinopathy was 30.67% (95% CI= 26.94%, 34.53%). Low HDI countries and very high HDI countries had the highest 63.55% (95% CI= 52.37%, 74.04%) and the lowest 22.59 (95% CI= 20.53, 24.71%) diabetic retinopathy prevalence. The meta-regression analysis showed that HDI had a significant negative moderating effect (p <0.0001), publication year had not a significant modulator effect (p = 0.6679), and the mean duration of diagnosed diabetes had a significant positive moderating effect (p <0.0001) on the prevalence of retinopathy in diabetes. Conclusions: We estimated a high prevalence of diabetic retinopathy in EMR. Our results implicate the importance of diabetes screening, on-time and periodic examinations for retinopathy, diabetes care, and risk factor controls.