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DOI: 10.1055/a-2108-6758
Volkskrankheit diabetische Retinopathie
Article in several languages: deutsch | EnglishZusammenfassung
Die diabetische Retinopathie (DR) ist eine der häufigsten Komplikationen von Diabetes mellitus und eine der häufigsten Ursachen einer Sehminderung im Erwerbsalter in der westlichen Welt. Die Behandlung der DR hängt von der Ausprägung ab, daher ist es von großer Bedeutung, die Patienten möglichst früh zu detektieren, um eine frühzeitige Behandlung einzuleiten und das Sehvermögen zu erhalten. Trotz derzeit unzureichender Screeningteilnahme frequentieren Menschen mit Diabetes bereits überdurchschnittlich häufig augenärztliche Praxen und Kliniken. Ihre Betreuung samt Diagnostik und Therapie nimmt seit Jahren einen wachsenden Anteil der augenärztlichen Tätigkeit ein. Da weltweit die Diabetesprävalenz dramatisch zunimmt und auch für Deutschland eine weitere Zunahme prognostiziert wird, dürfte die Herausforderung für die Augenärztinnen und Augenärzte noch erheblich wachsen. Gleichzeitig werden die diagnostischen Möglichkeiten zur Differenzierung einer DR und die therapeutischen Maßnahmen – gerade mit der IVOM-Therapie – immer aufwendiger, was die zeitliche Belastung im klinischen Alltag erhöht. Die Hoffnung, Versorgungsengpässe zu vermeiden und Screeningraten sowie die Visusprognose bei Patienten mit DR weiter zu verbessern, beruht u. a. auf einem kameraassistierten Screening, unterstützt durch künstliche Intelligenz. Auch eine bessere Diabetesbehandlung, um die Prävalenz der DR zu senken, sowie länger wirksamere Medikamente für die Behandlung einer DR könnten in der Zukunft die Versorgung der Betroffenen verbessern und helfen, augenärztliche Praxen zu entlasten.
Schlüsselwörter
diabetische Retinopathie - diabetisches Makulaödem - Vorsorgeuntersuchung - Diabetes mellitusPublication History
Received: 11 May 2023
Accepted: 19 May 2023
Article published online:
04 September 2023
© 2023. Thieme. All rights reserved.
Georg Thieme Verlag KG
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References/Literatur
- 1 Saeedi P, Petersohn I, Salpea P. et al. Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: Results from the International Diabetes Federation Diabetes Atlas, 9th edition. Diabetes Res Clin Pract 2019; 157: 107843 DOI: 10.1016/j.diabres.2019.107843.
- 2 Ogurtsova K, Guariguata L, Barengo NC. et al. IDF diabetes Atlas: Global estimates of undiagnosed diabetes in adults for 2021. Diabetes Res Clin Pract 2022; 183: 109118 DOI: 10.1016/j.diabres.2021.109118.
- 3 Diaz-Valencia PA, Bougnères P, Valleron AJ. Global epidemiology of type 1 diabetes in young adults and adults: a systematic review. BMC Public Health 2015; 15: 255 DOI: 10.1186/s12889-015-1591-y.
- 4 Tuomi T, Groop LC, Zimmet PZ. et al. Antibodies to glutamic acid decarboxylase reveal latent autoimmune diabetes mellitus in adults with a non-insulin-dependent onset of disease. Diabetes 1993; 42: 359-362 DOI: 10.2337/diab.42.2.359.
- 5 Ahlqvist E, Storm P, Käräjämäki A. et al. Novel subgroups of adult-onset diabetes and their association with outcomes: a data-driven cluster analysis of six variables. Lancet Diabetes Endocrinol 2018; 6: 361-369 DOI: 10.1016/S2213-8587(18)30051-2.
- 6 Ponto KA, Koenig J, Peto T. et al. Prevalence of diabetic retinopathy in screening-detected diabetes mellitus: results from the Gutenberg Health Study (GHS). Diabetologia 2016; 59: 1913-1919 DOI: 10.1007/s00125-016-4013-5.
- 7 Schuster AK, Wolfram C, Pfeiffer N. et al. Augenheilkunde 2019 – Wo stehen wir?. Ophthalmologe 2019; 116: 829-837 DOI: 10.1007/s00347-019-0894-2.
- 8 Rathmann W, Giani G. Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes Care 2004; 27: 2568-2569 DOI: 10.2337/diacare.27.10.2568.
- 9 World Health Organization (WHO). TADDS: tool for the assessment of diabetic retinopathy and diabetes management systems. Im Internet (Stand: 17.04.2023): https://www.who.int/publications/i/item/tadds-tool-for-the-assessment-of-diabetic-retinopathy-and-diabetes-management-systems
- 10 Hainsworth DP, Bebu I, Aiello LP. et al. Risk Factors for Retinopathy in Type 1 Diabetes: The DCCT/EDIC Study. Diabetes Care 2019; 42: 875-882 DOI: 10.2337/dc18-2308.
- 11 Basina M, Maahs DM. Age at type 1 diabetes onset: a new risk factor and call for focused treatment. The Lancet 2018; 392: 453-454 DOI: 10.1016/S0140-6736(18)31811-7.
- 12 Teo ZL, Tham YC, Yu M. et al. Global Prevalence of Diabetic Retinopathy and Projection of Burden through 2045: Systematic Review and Meta-analysis. Ophthalmology 2021; 128: 1580-1591 DOI: 10.1016/j.ophtha.2021.04.027.
- 13 Li JQ, Welchowski T, Schmid M. et al. Prevalence, incidence and future projection of diabetic eye disease in Europe: a systematic review and meta-analysis. Eur J Epidemiol 2020; 35: 11-23 DOI: 10.1007/s10654-019-00560-z.
- 14 Teo ZL, Tham YC, Yu M. et al. Do we have enough ophthalmologists to manage vision-threatening diabetic retinopathy? A global perspective. Eye (Lond) 2020; 34: 1255-1261 DOI: 10.1038/s41433-020-0776-5.
- 15 Hristova E, Koseva D, Zlatarova Z. et al. Diabetic Retinopathy Screening and Registration in Europe-Narrative Review. Healthcare (Basel) 2021; 9: 745 DOI: 10.3390/healthcare9060745.
- 16 Schmidt C, Reitzle L, Dreß J. et al. [Prevalence and incidence of documented diabetes based on health claims data-reference analysis for diabetes surveillance in Germany]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2020; 63: 93-102 DOI: 10.1007/s00103-019-03068-9.
- 17 Hesse L, Grüsser M, Hoffstadt K. et al. [Population-based study of diabetic retinopathy in Wolfsburg]. Ophthalmologe 2001; 98: 1065-1068 DOI: 10.1007/s003470170026.
- 18 Hammes HP, Welp R, Kempe HP. et al. Risk Factors for Retinopathy and DME in Type 2 Diabetes-Results from the German/Austrian DPV Database. PLoS One 2015; 10: e0132492 DOI: 10.1371/journal.pone.0132492.
- 19 Hammes HP, Kerner W, Hofer S. et al. Diabetic retinopathy in type 1 diabetes – a contemporary analysis of 8,784 patients. Diabetologia 2011; 54: 1977-1984 DOI: 10.1007/s00125-011-2198-1.
- 20 Groos S, Kretschmann J, Weber A. et al. Qualitätsbericht 2021: Disease-Management-Programme in Nordrhein. Im Internet (Stand: 17.07.2023): https://www.kgnw.de/service/dmp/dmp-nordrhein-qualitaetsbericht-2021
- 21 Blum M, Kloos C, Müller N. et al. [Prevalence of diabetic retinopathy. Check-up program of a public health insurance company in Germany 2002–2004]. Ophthalmologe 2007; 104: 499-500 502–504 DOI: 10.1007/s00347-007-1522-0.
- 22 Huppertz E, Pieper L, Klotsche J. et al. Diabetes Mellitus in German Primary Care: quality of glycaemic control and subpopulations not well controlled – results of the DETECT study. Exp Clin Endocrinol Diabetes 2009; 117: 6-14 DOI: 10.1055/s-2008-1073127.
- 23 Heller T, Blum M, Spraul M. et al. [Diabetic co-morbidities: prevalences in Germany]. Dtsch Med Wochenschr 2014; 139: 786-791 DOI: 10.1055/s-0034-1369889.
- 24 Goffrier B, Schulz M, Bätzing-Feigenbaum J. Administrative Prävalenzen und Inzidenzen des Diabetes mellitus von 2009 bis 2015. Versorgungsatlas-Bericht Nr. 17/03. 23.02.2017. Im Internet (Stand: 17.07.2023): https://www.versorgungsatlas.de/themen/alle-analysen-nach-datum-sortiert/?tab=6&uid=79 DOI: 10.20364/VA-17.03
- 25 Wilke RGH, Finger RP, Sachs HG. [Real-life Data on the Treatment of Diabetic Macular Oedema in Germany]. Klin Monbl Augenheilkd 2017; 234: 1502-1507 DOI: 10.1055/s-0043-115901.
- 26 Stefanickova J, Cunha-Vaz J, Ulbig M. et al. A noninterventional study to monitor patients with diabetic macular oedema starting treatment with ranibizumab (POLARIS). Acta Ophthalmol 2018; 96: e942-e949 DOI: 10.1111/aos.13771.
- 27 Faatz H, Rothaus K, Westhues D. et al. [Treatment adherence and effectiveness of anti-Vascular Endothelial Growth Faktor (VEGF) treatment of diabetic macular edema in the clinical routine: Comparison between cooperative and unicentric organization of treatment]. Ophthalmologe 2020; 117: 557-565 DOI: 10.1007/s00347-019-00977-7.
- 28 Finger RP, Fimmers R, Holz FG. et al. Incidence of blindness and severe visual impairment in Germany: projections for 2030. Invest Ophthalmol Vis Sci 2011; 52: 4381-4389 DOI: 10.1167/iovs.10-6987.
- 29 Antonetti DA, Klein R, Gardner TW. Diabetic retinopathy. N Engl J Med 2012; 366: 1227-1239 DOI: 10.1056/NEJMra1005073.
- 30 Antonetti DA, Silva PS, Stitt AW. Current understanding of the molecular and cellular pathology of diabetic retinopathy. Nat Rev Endocrinol 2021; 17: 195-206 DOI: 10.1038/s41574-020-00451-4.
- 31 Yau JWY, Rogers SL, Kawasaki R. et al. Global prevalence and major risk factors of diabetic retinopathy. Diabetes Care 2012; 35: 556-564 DOI: 10.2337/dc11-1909.
- 32 Lachin JM, Genuth S, Nathan DM. et al. Effect of glycemic exposure on the risk of microvascular complications in the diabetes control and complications trial–revisited. Diabetes 2008; 57: 995-1001 DOI: 10.2337/db07-1618.
- 33 Zhao M, Gelize E, Levy R. et al. Mineralocorticoid Receptor Pathway and Its Antagonism in a Model of Diabetic Retinopathy. Diabetes 2021; 70: 2668-2682 DOI: 10.2337/db21-0099.
- 34 Reid LJ, Gibb FW, Colhoun H. et al. Continuous subcutaneous insulin infusion therapy is associated with reduced retinopathy progression compared with multiple daily injections of insulin. Diabetologia 2021; 64: 1725-1736 DOI: 10.1007/s00125-021-05456-w.
- 35 Zhang P, Kumar A, Katz LS. et al. Induction of the ChREBPβ Isoform Is Essential for Glucose-Stimulated β-Cell Proliferation. Diabetes 2015; 64: 4158-4170 DOI: 10.2337/db15-0239.
- 36 Do DV, Han G, Abariga SA. et al. Blood pressure control for diabetic retinopathy. Cochrane Database Syst Rev 2023; (03) CD006127 DOI: 10.1002/14651858.CD006127.pub3.
- 37 Keech AC, Mitchell P, Summanen PA. et al. Effect of fenofibrate on the need for laser treatment for diabetic retinopathy (FIELD study): a randomised controlled trial. Lancet 2007; 370: 1687-1697 DOI: 10.1016/S0140-6736(07)61607-9.
- 38 Meer E, Bavinger JC, Yu Y. et al. Association of Fenofibrate Use and the Risk of Progression to Vision-Threatening Diabetic Retinopathy. JAMA Ophthalmol 2022; 140: 529-532 DOI: 10.1001/jamaophthalmol.2022.0633.
- 39 Li Y, Su X, Ye Q. et al. The predictive value of diabetic retinopathy on subsequent diabetic nephropathy in patients with type 2 diabetes: a systematic review and meta-analysis of prospective studies. Ren Fail 2021; 43: 231-240 DOI: 10.1080/0886022X.2020.1866010.
- 40 Cosentino F, Grant PJ, Aboyans V. et al. 2019 ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD. Eur Heart J 2020; 41: 255-323 DOI: 10.1093/eurheartj/ehz486.
- 41 Ziemssen F, Lemmen K, Bertram B. et al. [National guidelines for treatment of diabetic retinopathy: Second edition of the national guidelines for treatment of diabetic retinopathy]. Ophthalmologe 2016; 113: 623-638 DOI: 10.1007/s00347-016-0315-8.
- 42 Wang J, Xin X, Luo W. et al. Anemia and Diabetic Kidney Disease Had Joint Effect on Diabetic Retinopathy Among Patients With Type 2 Diabetes. Invest Ophthalmol Vis Sci 2020; 61: 25 DOI: 10.1167/iovs.61.14.25.
- 43 [Anonymous] Early photocoagulation for diabetic retinopathy. ETDRS report number 9. Early Treatment Diabetic Retinopathy Study Research Group. Ophthalmology 1991; 98 (5 Suppl): 766-785
- 44 Writing Committee for the Diabetic Retinopathy Clinical Research Network. Fong DS, Strauber SF, Aiello LP. et al. Comparison of the modified Early Treatment Diabetic Retinopathy Study and mild macular grid laser photocoagulation strategies for diabetic macular edema. Arch Ophthalmol 2007; 125: 469-480 DOI: 10.1001/archopht.125.4.469.
- 45 [Anonymous] Photocoagulation for diabetic macular edema. Early Treatment Diabetic Retinopathy Study report number 1. Early Treatment Diabetic Retinopathy Study research group. Arch Ophthalmol 1985; 103: 1796-1806
- 46 Zhang X, Saaddine JB, Chou CF. et al. Prevalence of diabetic retinopathy in the United States, 2005–2008. JAMA 2010; 304: 649-656 DOI: 10.1001/jama.2010.1111.
- 47 Claessen H, Kvitkina T, Narres M. et al. Markedly Decreasing Incidence of Blindness in People With and Without Diabetes in Southern Germany. Diabetes Care 2018; 41: 478-484 DOI: 10.2337/dc17-2031.
- 48 Scanlon PH. The English National Screening Programme for diabetic retinopathy 2003–2016. Acta Diabetol 2017; 54: 515-525 DOI: 10.1007/s00592-017-0974-1.
- 49 Bertram B, Gante C, Hilgers RD. [Increase in examinations for cataracts, glaucoma, diabetic retinopathy and age-related macular degeneration: Comparative cross-sectional study between 2010 and 1997 in ophthalmological practices]. Ophthalmologe 2014; 111: 757-764 DOI: 10.1007/s00347-013-2966-z.
- 50 Schuster AK, Wolfram C, Pfeiffer N. et al. [Ophthalmology 2019-where do we stand?: An analysis of the treatment situation in Germany]. Ophthalmologe 2019; 116: 829-837 DOI: 10.1007/s00347-019-0894-2.
- 51 Schuster AK, Wolfram C, Bertram B. et al. [Who visits an ophthalmologist and how often? Results of the German nationwide adult health survey (DEGS1)]. Ophthalmologe 2018; 115: 1042-1049 DOI: 10.1007/s00347-017-0613-9.
- 52 Kreft D, McGuinness MB, Doblhammer G. et al. Diabetic retinopathy screening in incident diabetes mellitus type 2 in Germany between 2004 and 2013 – A prospective cohort study based on health claims data. PLoS One 2018; 13: e0195426 DOI: 10.1371/journal.pone.0195426.
- 53 Baumeister SE, Schomerus G, Andersen RM. et al. Trends of barriers to eye care among adults with diagnosed diabetes in Germany, 1997–2012. Nutr Metab Cardiovasc Dis 2015; 25: 906-915 DOI: 10.1016/j.numecd.2015.07.003.
- 54 Wenzel M, Schayan K, Wirbelauer C. et al. Ambulante und stationäre Intraokularchirurgie 2020/21: Ergebnisse der aktuellen Umfrage im Corona-Jahr von BDOC, BVA, DGII und DOG. Im Internet (Stand: 17.07.2023): http://bdoc.info/dl/aktuelles_ambulante-intraokularchirurgie_wenzel-et-al-umfrage-2020.pdf
- 55 Wenzel M, Kohnen T, Scharrer A. et al. Umfrage von DGII, BVA und BDOC zur ambulanten Intraokularchirurgie 2009. 2010. Im Internet (Stand: 17.07.2023): https://www.dgii.org/uploads/jahresband/2010/Wenzel.pdf
- 56 König SF, Spital G, Ziemssen F. et al. [Photo-based examination for diabetic eye pathologies in a German ophthalmological practice without personal doctor-patient contact]. Ophthalmologie 2023; 120: 301-308 DOI: 10.1007/s00347-022-01737-w.
- 57 Paul S, Tayar A, Morawiec-Kisiel E. et al. [Use of artificial intelligence in screening for diabetic retinopathy at a tertiary diabetes center]. Ophthalmologie 2022; 119: 705-713 DOI: 10.1007/s00347-021-01556-5.
- 58 Stebbins K, Kieltyka S, Chaum E. Follow-Up Compliance for Patients Diagnosed with Diabetic Retinopathy After Teleretinal Imaging in Primary Care. Telemed J E Health 2021; 27: 303-307 DOI: 10.1089/tmj.2019.0264.
- 59 Channa R, Wolf RM, Abràmoff MD. et al. Effectiveness of artificial intelligence screening in preventing vision loss from diabetes: a policy model. NPJ Digit Med 2023; 6: 53 DOI: 10.1038/s41746-023-00785-z.
- 60 Rajalakshmi R, Subashini R, Anjana RM. et al. Automated diabetic retinopathy detection in smartphone-based fundus photography using artificial intelligence. Eye (Lond) 2018; 32: 1138-1144 DOI: 10.1038/s41433-018-0064-9.
- 61 Kumari S, Venkatesh P, Tandon N. et al. Selfie fundus imaging for diabetic retinopathy screening. Eye (Lond) 2022; 36: 1988-1993 DOI: 10.1038/s41433-021-01804-7.
- 62 Ryu G, Lee K, Park D. et al. A deep learning model for identifying diabetic retinopathy using optical coherence tomography angiography. Sci Rep 2021; 11: 23024 DOI: 10.1038/s41598-021-02479-6.
- 63 Maturi RK, Glassman AR, Josic K. et al. Effect of Intravitreous Anti-Vascular Endothelial Growth Factor vs. Sham Treatment for Prevention of Vision-Threatening Complications of Diabetic Retinopathy: The Protocol W Randomized Clinical Trial. JAMA Ophthalmol 2021; 139: 701-712 DOI: 10.1001/jamaophthalmol.2021.0606.