Prevalence of Diabetic Retinopathy in Rural China

The Handan Eye Study

Feng Hua Wang, Yuan Bo Liang, Feng Zhang, Jie Jin Wang, Wen Bin Wei, Qiu Shan Tao, Lan Ping Sun, David S Friedman, Ning Li Wang, Tien Yin Wong

Research output: Contribution to journalArticle

Abstract

Purpose: To describe the age- and gender-specific prevalence, characteristics, and severity of diabetic retinopathy (DR) in a rural population in northern China. Design: A population-based cross-sectional study. Participants: A total of 6830 Han Chinese aged 30 years and older from 13 villages of Yongnian County, Handan City, Hebei Province, China. Methods: All participants underwent a standardized interview, a comprehensive eye examination, and fasting blood glucose testing according to the American Diabetes Association diagnostic criteria (fasting plasma glucose ≥7.0 mmol/l). Retinal photographs obtained after pupil dilation were graded for the presence and severity of DR according to the modified Early Treatment Diabetic Retinopathy Study classification system. Main Outcome Measures: Any DR, retinopathy grades, macular edema, or vision-threatening retinopathy. Results: Of the 6830 eligible individuals participating in the study, 5597 (81.9%) had fasting blood glucose results available. Of these, 387 participants (6.9%) were diagnosed with diabetes mellitus, including 247 subjects with new diabetes mellitus (NDM) and 140 subjects with known diabetes mellitus (KDM). For these, gradable photographs were available for 368 subjects (95.1%). The overall prevalence of DR was 43.1% (95% confidence interval, 38.1-48.4) and was higher in persons with KDM (65.2%) than NDM (33.5%). The prevalence of proliferative DR, macular edema, and vision-threatening retinopathy was 1.6%, 5.2%, and 6.3%, respectively, with 12.1% with KDM having untreated vision-threatening DR. No age- or gender-related differences were present. The prevalence of DR was strongly related to duration of disease. Conclusions: Our study reports a high prevalence of DR among adults 30 years and older with diabetes in rural China. On the basis of estimates obtained from our study, we projected that in rural China, 21.1 million persons aged 30+ years have diabetes and 9.2 million have DR, including 1.3 million with vision-threatening DR. There is a pressing need for appropriate screening and management of diabetes and its complications in rural China. Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article.

Original languageEnglish (US)
Pages (from-to)461-467
Number of pages7
JournalOphthalmology
Volume116
Issue number3
DOIs
StatePublished - Mar 2009

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Diabetic Retinopathy
China
Diabetes Mellitus
Fasting
Macular Edema
Blood Glucose
Disclosure
Rural Population
Diabetes Complications
Pupil
Dilatation
Cross-Sectional Studies
Outcome Assessment (Health Care)
Confidence Intervals
Interviews
Glucose

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Wang, F. H., Liang, Y. B., Zhang, F., Wang, J. J., Wei, W. B., Tao, Q. S., ... Wong, T. Y. (2009). Prevalence of Diabetic Retinopathy in Rural China: The Handan Eye Study. Ophthalmology, 116(3), 461-467. https://doi.org/10.1016/j.ophtha.2008.10.003

Prevalence of Diabetic Retinopathy in Rural China : The Handan Eye Study. / Wang, Feng Hua; Liang, Yuan Bo; Zhang, Feng; Wang, Jie Jin; Wei, Wen Bin; Tao, Qiu Shan; Sun, Lan Ping; Friedman, David S; Wang, Ning Li; Wong, Tien Yin.

In: Ophthalmology, Vol. 116, No. 3, 03.2009, p. 461-467.

Research output: Contribution to journalArticle

Wang, FH, Liang, YB, Zhang, F, Wang, JJ, Wei, WB, Tao, QS, Sun, LP, Friedman, DS, Wang, NL & Wong, TY 2009, 'Prevalence of Diabetic Retinopathy in Rural China: The Handan Eye Study', Ophthalmology, vol. 116, no. 3, pp. 461-467. https://doi.org/10.1016/j.ophtha.2008.10.003
Wang FH, Liang YB, Zhang F, Wang JJ, Wei WB, Tao QS et al. Prevalence of Diabetic Retinopathy in Rural China: The Handan Eye Study. Ophthalmology. 2009 Mar;116(3):461-467. https://doi.org/10.1016/j.ophtha.2008.10.003
Wang, Feng Hua ; Liang, Yuan Bo ; Zhang, Feng ; Wang, Jie Jin ; Wei, Wen Bin ; Tao, Qiu Shan ; Sun, Lan Ping ; Friedman, David S ; Wang, Ning Li ; Wong, Tien Yin. / Prevalence of Diabetic Retinopathy in Rural China : The Handan Eye Study. In: Ophthalmology. 2009 ; Vol. 116, No. 3. pp. 461-467.
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abstract = "Purpose: To describe the age- and gender-specific prevalence, characteristics, and severity of diabetic retinopathy (DR) in a rural population in northern China. Design: A population-based cross-sectional study. Participants: A total of 6830 Han Chinese aged 30 years and older from 13 villages of Yongnian County, Handan City, Hebei Province, China. Methods: All participants underwent a standardized interview, a comprehensive eye examination, and fasting blood glucose testing according to the American Diabetes Association diagnostic criteria (fasting plasma glucose ≥7.0 mmol/l). Retinal photographs obtained after pupil dilation were graded for the presence and severity of DR according to the modified Early Treatment Diabetic Retinopathy Study classification system. Main Outcome Measures: Any DR, retinopathy grades, macular edema, or vision-threatening retinopathy. Results: Of the 6830 eligible individuals participating in the study, 5597 (81.9{\%}) had fasting blood glucose results available. Of these, 387 participants (6.9{\%}) were diagnosed with diabetes mellitus, including 247 subjects with new diabetes mellitus (NDM) and 140 subjects with known diabetes mellitus (KDM). For these, gradable photographs were available for 368 subjects (95.1{\%}). The overall prevalence of DR was 43.1{\%} (95{\%} confidence interval, 38.1-48.4) and was higher in persons with KDM (65.2{\%}) than NDM (33.5{\%}). The prevalence of proliferative DR, macular edema, and vision-threatening retinopathy was 1.6{\%}, 5.2{\%}, and 6.3{\%}, respectively, with 12.1{\%} with KDM having untreated vision-threatening DR. No age- or gender-related differences were present. The prevalence of DR was strongly related to duration of disease. Conclusions: Our study reports a high prevalence of DR among adults 30 years and older with diabetes in rural China. On the basis of estimates obtained from our study, we projected that in rural China, 21.1 million persons aged 30+ years have diabetes and 9.2 million have DR, including 1.3 million with vision-threatening DR. There is a pressing need for appropriate screening and management of diabetes and its complications in rural China. Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article.",
author = "Wang, {Feng Hua} and Liang, {Yuan Bo} and Feng Zhang and Wang, {Jie Jin} and Wei, {Wen Bin} and Tao, {Qiu Shan} and Sun, {Lan Ping} and Friedman, {David S} and Wang, {Ning Li} and Wong, {Tien Yin}",
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AU - Wei, Wen Bin

AU - Tao, Qiu Shan

AU - Sun, Lan Ping

AU - Friedman, David S

AU - Wang, Ning Li

AU - Wong, Tien Yin

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N2 - Purpose: To describe the age- and gender-specific prevalence, characteristics, and severity of diabetic retinopathy (DR) in a rural population in northern China. Design: A population-based cross-sectional study. Participants: A total of 6830 Han Chinese aged 30 years and older from 13 villages of Yongnian County, Handan City, Hebei Province, China. Methods: All participants underwent a standardized interview, a comprehensive eye examination, and fasting blood glucose testing according to the American Diabetes Association diagnostic criteria (fasting plasma glucose ≥7.0 mmol/l). Retinal photographs obtained after pupil dilation were graded for the presence and severity of DR according to the modified Early Treatment Diabetic Retinopathy Study classification system. Main Outcome Measures: Any DR, retinopathy grades, macular edema, or vision-threatening retinopathy. Results: Of the 6830 eligible individuals participating in the study, 5597 (81.9%) had fasting blood glucose results available. Of these, 387 participants (6.9%) were diagnosed with diabetes mellitus, including 247 subjects with new diabetes mellitus (NDM) and 140 subjects with known diabetes mellitus (KDM). For these, gradable photographs were available for 368 subjects (95.1%). The overall prevalence of DR was 43.1% (95% confidence interval, 38.1-48.4) and was higher in persons with KDM (65.2%) than NDM (33.5%). The prevalence of proliferative DR, macular edema, and vision-threatening retinopathy was 1.6%, 5.2%, and 6.3%, respectively, with 12.1% with KDM having untreated vision-threatening DR. No age- or gender-related differences were present. The prevalence of DR was strongly related to duration of disease. Conclusions: Our study reports a high prevalence of DR among adults 30 years and older with diabetes in rural China. On the basis of estimates obtained from our study, we projected that in rural China, 21.1 million persons aged 30+ years have diabetes and 9.2 million have DR, including 1.3 million with vision-threatening DR. There is a pressing need for appropriate screening and management of diabetes and its complications in rural China. Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article.

AB - Purpose: To describe the age- and gender-specific prevalence, characteristics, and severity of diabetic retinopathy (DR) in a rural population in northern China. Design: A population-based cross-sectional study. Participants: A total of 6830 Han Chinese aged 30 years and older from 13 villages of Yongnian County, Handan City, Hebei Province, China. Methods: All participants underwent a standardized interview, a comprehensive eye examination, and fasting blood glucose testing according to the American Diabetes Association diagnostic criteria (fasting plasma glucose ≥7.0 mmol/l). Retinal photographs obtained after pupil dilation were graded for the presence and severity of DR according to the modified Early Treatment Diabetic Retinopathy Study classification system. Main Outcome Measures: Any DR, retinopathy grades, macular edema, or vision-threatening retinopathy. Results: Of the 6830 eligible individuals participating in the study, 5597 (81.9%) had fasting blood glucose results available. Of these, 387 participants (6.9%) were diagnosed with diabetes mellitus, including 247 subjects with new diabetes mellitus (NDM) and 140 subjects with known diabetes mellitus (KDM). For these, gradable photographs were available for 368 subjects (95.1%). The overall prevalence of DR was 43.1% (95% confidence interval, 38.1-48.4) and was higher in persons with KDM (65.2%) than NDM (33.5%). The prevalence of proliferative DR, macular edema, and vision-threatening retinopathy was 1.6%, 5.2%, and 6.3%, respectively, with 12.1% with KDM having untreated vision-threatening DR. No age- or gender-related differences were present. The prevalence of DR was strongly related to duration of disease. Conclusions: Our study reports a high prevalence of DR among adults 30 years and older with diabetes in rural China. On the basis of estimates obtained from our study, we projected that in rural China, 21.1 million persons aged 30+ years have diabetes and 9.2 million have DR, including 1.3 million with vision-threatening DR. There is a pressing need for appropriate screening and management of diabetes and its complications in rural China. Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article.

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