title: Mini Review: Changes in the Incidence of and Progression to Proliferative and Sight-Threatening Diabetic Retinopathy Over the Last 30 Years.
abstract: Diabetic retinopathy is a leading cause of blindness worldwide. The last 3 decades have seen major improvements in glycemic and blood pressure control as well as the introduction of national screening programs, and we sought to determine if rates of proliferative diabetic retinopathy have changed as a result.
  
  
  
  We conducted a systematic review to determine whether the incidence and progression rates of proliferative diabetic retinopathy and sight-threatening retinopathy have changed, focusing on large population-based studies with objective assessment of diabetic retinopathy.
  
  
  
  Comparisons across different studies is problematic due to different baseline retinopathy severity, different reported outcomes and different follow-up periods, but within these constraints certain trends could be identified. This review provides evidence that the incidence and progression of these conditions has reduced by approximately 2-3 fold over the last 3 decades.
  
  
  
  These results have implications for current diabetic retinopathy screening guidelines and has identified future areas where research could be improved.
authors.affiliation: a Centre for Vision Research, Westmead Millennium Institute of Medical Research , University of Sydney , Sydney , Australia.
authors.forename: Gerald
authors.initials: G
authors.lastname: Liew
authors.affiliation: b Liverpool Diabetes Collaborative Research Unit , Ingham Institute of Applied Science , Sydney , Australia.
authors.forename: Vincent W
authors.initials: VW
authors.lastname: Wong
authors.affiliation: c Save Sight Institute , University of Sydney , Sydney , Australia.|d Australian School of Advanced Medicine , Macquarie University , Sydney , Australia.
authors.forename: I-Van
authors.initials: IV
authors.lastname: Ho
mesh_terms: D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D003930:Diabetic Retinopathy / Q000453:epidemiology*; D018450:Disease Progression; D006801:Humans; D015994:Incidence; D013997:Time Factors
keywords: Diabetes; diabetic retinopathy; epidemiology; proliferative diabetic retinopathy; review