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March 4, 2025 – A recent study conducted by researchers at the Perelman School of Medicine at the University of Pennsylvania has found that while the prevalence of diabetes-related eye diseases has nearly doubled since 2014, the rates of the most severe forms have significantly decreased. The findings, published in Ophthalmology, highlight the progress made in diagnosing and managing diabetes in the United States, while also hinting at future challenges related to vision-threatening diseases.
Key Findings According to the study, more than 30% of individuals with diabetes now suffer from some form of diabetic retinal disease, putting millions at risk for vision impairment. However, the most severe forms of the disease, which can lead to blindness, have become less common.
Lead author Dr. Brian VanderBeek, an associate professor of Ophthalmology, explained, “Our work suggests that while more cases of diabetic retinal disease are being identified, advancements in diabetes treatment may be preventing the most serious complications.”
With over 38 million Americans diagnosed with diabetes and an additional 98 million classified as pre-diabetic, understanding the full scope of diabetic eye disease is crucial for public health efforts.
Analyzing the Data To assess the impact of diabetes on eye health, researchers analyzed deidentified medical claims from more than six million patients diagnosed with diabetes between 2000 and 2022. The study focused on two key metrics:
- Prevalence: The percentage of people with diabetes who have some form of diabetic retinal disease.
- Incidence: The rate of new cases occurring over time.
Between 2014 and 2021, the prevalence of diabetes-related retinal diseases increased from 10.8% to 20.8%, and the incidence rate nearly doubled from its lowest point in 2013 (17.7 new cases per 1,000 person-years) to 32.2 in 2022.
However, vision-threatening diabetic retinal diseases saw a decline in severity. The most serious forms of the disease decreased by 10% in prevalence over recent years, while incidence rates for all vision-threatening conditions dropped by 51% between 2009 and 2022. Notably, the incidence rate of proliferative diabetic retinopathy—a severe form of the disease—declined by nearly 300% since 2002, from 8.3 per 1,000 person-years to 2.6 in 2022.
Interpreting the Trends The study offers two possible explanations for these findings:
- The overall increase in diabetic retinal disease diagnoses may signal a forthcoming rise in severe cases yet to be fully reflected in the data.
- Improved diabetes management and healthcare accessibility, particularly following the implementation of the Affordable Care Act, have led to better outcomes, reducing the incidence of the most severe complications.
“Better insurance coverage has provided more individuals with access to routine screenings and early interventions,” said VanderBeek. “This has likely contributed to the decline in severe cases.”
Next Steps in Research The research team plans to delve deeper into their findings by examining disparities across racial and ethnic groups and investigating differences between Type 1 and Type 2 diabetes patients.
For more information, refer to the study: Brian L. VanderBeek et al, Twenty-Year Trends in Prevalence and Incidence of Diabetic Retinal Disease, Ophthalmology (2025). DOI: 10.1016/j.ophtha.2025.01.022.
Disclaimer: This article is for informational purposes only and does not constitute medical advice. Readers should consult healthcare professionals for guidance on diabetes management and eye health.
