title: Prevalence of and risk factors for diabetic macular edema in the United States.
abstract: OBJECTIVE
  Diabetic macular edema (DME) is a leading cause of vision loss in persons with diabetes mellitus. Although there are national estimates for the prevalence of diabetic retinopathy and its risk factors among persons with diabetes, to our knowledge, no comparable estimates are available for DME specifically.
  
  
  OBJECTIVE
  To estimate the prevalence of DME in the US population and to identify associated risk factors.
  
  
  METHODS
  A cross-sectional analysis of 1038 participants aged 40 years or older with diabetes and valid fundus photographs in the 2005 to 2008 National Health and Nutrition Examination Survey.
  
  
  METHODS
  The overall prevalence of DME and its prevalence according to age, race/ethnicity, and sex.
  
  
  RESULTS
  Of the 1038 persons with diabetes analyzed for this study, 55 had DME, for an overall weighted prevalence of 3.8% (95% CI, 2.7%-4.9%) or approximately 746, 000 persons in the US 2010 population aged 40 years or older. We identified no differences in the prevalence of DME by age or sex. Multivariable logistic regression analysis showed that the odds of having DME were higher for non-Hispanic blacks than for non-Hispanic whites (odds ratio [OR], 2.64; 95% CI, 1.19-5.84; P = .02). Elevated levels of glycosylated hemoglobin A1c (OR, 1.47; 95% CI, 1.26-1.71 for each 1%; P < .001) and longer duration of diabetes (OR, 8.51; 95% CI, 3.70-19.54 for ≥ 10 vs <10 years; P < .001) were also associated with DME prevalence.
  
  
  CONCLUSIONS
  These results suggest a greater burden of DME among non-Hispanic blacks, individuals with high levels of hemoglobin A1c, and those with longer duration of diabetes. Given recent treatment advances in reducing vision loss and preserving vision in persons with DME, it is imperative that all persons with diabetes receive early screening; this recommendation is even more important for those at higher risk for DME.
authors.affiliation: USC Eye Institute, Keck School of Medicine, University of Southern California, Los Angeles.
authors.forename: Rohit
authors.initials: R
authors.lastname: Varma
authors.affiliation: Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland3Editor, JAMA Ophthalmology.
authors.forename: Neil M
authors.initials: NM
authors.lastname: Bressler
authors.affiliation: Outcomes Insights, Inc, Westlake Village, California.
authors.forename: Quan V
authors.initials: QV
authors.lastname: Doan
authors.affiliation: Outcomes Insights, Inc, Westlake Village, California.
authors.forename: Michelle
authors.initials: M
authors.lastname: Gleeson
authors.affiliation: Outcomes Insights, Inc, Westlake Village, California.
authors.forename: Mark
authors.initials: M
authors.lastname: Danese
authors.affiliation: Division of Epidemiology, The Ohio State University College of Public Health, Columbus.
authors.forename: Julie K
authors.initials: JK
authors.lastname: Bower
authors.affiliation: Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Selvin
authors.affiliation: Genentech, Inc, South San Francisco, California.
authors.forename: Chantal
authors.initials: C
authors.lastname: Dolan
authors.affiliation: Genentech, Inc, South San Francisco, California.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Fine
authors.affiliation: Genentech, Inc, South San Francisco, California.
authors.forename: Shoshana
authors.initials: S
authors.lastname: Colman
authors.affiliation: Genentech, Inc, South San Francisco, California.
authors.forename: Adam
authors.initials: A
authors.lastname: Turpcu
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D003430:Cross-Sectional Studies; D003930:Diabetic Retinopathy / Q000097:blood / Q000453:epidemiology*; D005006:Ethnicity / Q000706:statistics & numerical data; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006306:Health Surveys; D006801:Humans; D008269:Macular Edema / Q000097:blood / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D015995:Prevalence; D012307:Risk Factors; D017678:Sex Distribution; D014481:United States / Q000453:epidemiology
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human