The possibility of losing their vision is of great concern to individuals with diabetes, and with good reason. Diabetic retinopathy is the leading cause of blindness and visual impairment in people of working age in the UK1, with proliferative retinopathy and diabetic maculopathy being the key underlying pathologies.
There are, however, grounds for optimism. Firstly, preventative action through addressing risk factors for retinopathy can attenuate its onset and progression. Secondly, early identification of retinopathy via the National Screening process can allow timely intervention for managing proliferative retinopathy and maculopathy.
Risk factors and epidemiology
The Wisconsin epidemiological studies demonstrated that the occurrence and severity of retinopathy was associated with duration of diabetes, poor glycaemic control, raised blood pressure and the presence of proteinuria.2,3 In the case of individuals with type 1 diabetes, the vast majority (over 90%) will have some degree of retinopathy 15 years after diagnosis.2,4 For people with type 2 diabetes, around 25% have evidence of retinopathy within 2 years of diagnosis and over 60% will have a diagnosis of retinopathy within 15 years of diagnosis.3