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Risk factors for the development and progression of proliferative diabetic retinopathy (a diabetes complication affecting eyes)

Review question

We wanted to find out which factors may increase or reduce the chance that people with diabetes develop proliferative diabetic retinopathy (PDR) and high‐risk proliferative diabetic retinopathy, both sight‐threatening complications of diabetes.

Key results

Of the 6391 articles we found, 59 studies (87 articles) were eligible, and we included them in our review. We found that higher blood sugar (which means poorer diabetes control) and more advanced diabetic retinopathy (more changes from diabetes in the retina) put people at higher risk of having PDR. People with kidney disease seemed also to be at higher risk of progressing to PDR. It is also possible that people with type 1 diabetes who were diagnosed at a young age, and those with higher triglyceride levels (triglycerides are a type of fat in the blood, like cholesterol) or who have retinal veins with larger diameters, are more at risk of developing PDR. Other risk factors studied ‐ for example, duration of diabetes, blood pressure, and cholesterol ‐ did not seem to be risk factors for PDR. There was not enough information from the included studies for us to analyse risk factors for HRC‐PDR.

Authors' conclusions

People living with type 1 or type 2 diabetes who have poor blood sugar control are likely to be at increased risk of developing PDR. Evidence suggests that better blood sugar control, even in people who already have the earlier stages of diabetic retinopathy, may help to prevent it from progressing to PDR. Those with kidney disease may also be at increased risk of progressing to PDR. Additionally, people with type 1 diabetes, who were diagnosed at a younger age, or who have higher triglyceride levels or larger retinal veins, may be more susceptible to developing PDR.

Read the full Cochrane Review:

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