Prevalence of diabetic retinopathy in screening-detected diabetes mellitus: results from the Gutenberg Health Study (GHS).
Individuals with type 2 diabetes mellitus may experience an asymptomatic period of hyperglycaemia, and complications may already be present at the time of diagnosis. We aimed to determine the prevalence of diabetic retinopathy in patients with newly diagnosed (screening-detected) type 2 diabetes.



The Gutenberg Health Study is a population-based study with 15,010 participants aged between 35 and 74 years. We determined the weighted prevalence of diabetic retinopathy by assessing fundus photographs. Screening-detected type 2 diabetes was defined as an HbA1c concentration of 6.5% (47.5 mmol/mol) or more, no medical diagnosis of diabetes and no intake of insulin or oral glucose-lowering agents.



Of 14,948 participants, 1377 (9.2%) had diabetes mellitus. Of these, 347 (25.2%) had newly diagnosed type 2 diabetes detected by the screening. Overall, the weighted prevalence of screening-detected type 2 diabetes was 2.1%. Fundus photos were evaluable for 285 (82.1%) participants with newly diagnosed diabetes. The weighted prevalence of diabetic retinopathy in screening-detected type 2 diabetes was 13.0%; 12% of participants had a mild non-proliferative diabetic retinopathy and 0.6% had a moderate non-proliferative diabetic retinopathy. Diabetic retinopathy was proliferative in 0.3%. No cases of severe non-proliferative diabetic retinopathy or diabetic maculopathy were found. Thirty (14.9%) of 202 and six (7.2%) of 83 individuals with and without concomitant arterial hypertension, respectively, had diabetic retinopathy (OR 2.54, 95% CI 1.06, 7.14). Visual acuity did not differ between individuals with and without diabetic retinopathy .



In this large European study, the prevalence of diabetic retinopathy in screening-detected type 2 diabetes was 13%. Only a very small proportion of participants with detected diabetic retinopathy needed treatment.
Department of Ophthalmology, University Medical Center Mainz, Langenbeckstrasse 1, 55131, Mainz, Germany. katharina.ponto@unimedizin-mainz.de.|Center for Thrombosis and Hemostasis, University Medical Center, Mainz, Germany. katharina.ponto@unimedizin-mainz.de.
Katharina A
KA
Ponto
Institute of Medical Biostatistics, Epidemiology and Informatics, Division of Biostatistics and Bioinformatics, University Medical Center, Mainz, Germany.
Jochem
J
Koenig
NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK.
Tunde
T
Peto
Department of Ophthalmology, University Medical Center Mainz, Langenbeckstrasse 1, 55131, Mainz, Germany.
Julia
J
Lamparter
Department of Ophthalmology, University Medical Center Mainz, Langenbeckstrasse 1, 55131, Mainz, Germany.
Philipp
P
Raum
Center for Thrombosis and Hemostasis, University Medical Center, Mainz, Germany.|Preventive Cardiology and Preventive Medicine, Department of Medicine II, University Medical Center, Mainz, Germany.|DZHK (German Center for Cardiovascular Research), Partner Site Rhine Main, Mainz, Germany.
Philipp S
PS
Wild
Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center, Mainz, Germany.
Karl J
KJ
Lackner
Department of Ophthalmology, University Medical Center Mainz, Langenbeckstrasse 1, 55131, Mainz, Germany.
Norbert
N
Pfeiffer
Department of Ophthalmology, University Medical Center Mainz, Langenbeckstrasse 1, 55131, Mainz, Germany.|Dardenne Eye Hospital, Bonn-Bad Godesberg, Germany.
Alireza
A
Mirshahi
D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000453:epidemiology*; D003930:Diabetic Retinopathy / Q000097:blood / Q000453:epidemiology*; D050171:Dyslipidemias / Q000097:blood / Q000453:epidemiology; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000453:epidemiology; D008403:Mass Screening; D008875:Middle Aged; D009765:Obesity / Q000097:blood / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors
D001786:Blood Glucose; D006442:Glycated Hemoglobin
Diabetes mellitus; Epidemiology; Maculopathy; Microangiopathy; Retinopathy