{
  "abstract": "Background and aims The current study aims to investigate how age, period and cohort effects have shaped the patterns of diabetic retinopathy-related vision loss globally, distinguishing between loss associated with type 1 versus 2 diabetes.Methods A secondary analysis of data from the Global Burden of Disease (GBD) 2021 study was conducted by using estimates of blindness and vision loss due to DR across different socio-demographic index (SDI) categories. Age-standardised prevalence rates, relative percentage changes, net drift and local drift were analysed.Findings Globally, age-standardised prevalence (ASPR) of diabetes-related blindness and vision loss rose from 48.8 per 100 000 in 1990 to 67.3 per 100 000 in 2021, with type 1 diabetes-related blindness and vision loss ASPR showing a modest decrease (from 1.8 to 1.7 per 100 000). The highest relative increase was recorded in the high SDI group (45.8%). For Type 1 diabetes, low-middle and low SDI groups exhibited more pronounced declines in associated ASPR. Increasing ASPR with advancing age was consistent across SDI groups though less pronounced for type 1 than type 2 diabetes. Unfavourable period and cohort effects were observed for type 2 but not type 1-related blindness and vision loss risk. High-middle SDI and middle SDI groups showed the most notable increase in period and cohort effect, whereas low-middle and low SDI groups experienced favourable period and cohort risks during the study duration.Conclusions Substantially different trends were observed for ASPR, period and cohort effects in recent decades for type 1 versus type 2 diabetes across different SDI.",
  "authors": [
    {
      "affiliations": [
        "Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou, Guangdong, China",
        "Fifth Clinical Institute of Shantou University Medical College, Shantou, People's Republic of China",
        "GuangDong Engineering Technology Research Center of Precision Treatment for Ocular Diseases, Shantou, People's Republic of China"
      ],
      "name": "Zhiqiang Guan"
    },
    {
      "affiliations": [
        "Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou, Guangdong, China"
      ],
      "name": "Yongyi Li"
    },
    {
      "affiliations": [
        "Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou, Guangdong, China"
      ],
      "name": "Yuancun Li"
    },
    {
      "affiliations": [
        "Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou, Guangdong, China"
      ],
      "name": "Zhen Qian"
    },
    {
      "affiliations": [
        "Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou, Guangdong, China",
        "Fifth Clinical Institute of Shantou University Medical College, Shantou, People's Republic of China"
      ],
      "name": "Yali Du"
    },
    {
      "affiliations": [
        "Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou, Guangdong, China",
        "Fifth Clinical Institute of Shantou University Medical College, Shantou, People's Republic of China",
        "GuangDong Engineering Technology Research Center of Precision Treatment for Ocular Diseases, Shantou, People's Republic of China",
        "Guangdong Engineering Research Center of Intelligent Diagnosis and Treatment for Ocular Diseases, Shantou, People's Republic of China",
        "Shantou Key Laboratory of Ocular Disease Prevention,Treatment, and Research, Shantou, People's Republic of China"
      ],
      "name": "Shengjie Yin"
    },
    {
      "affiliations": [
        "Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou, Guangdong, China",
        "Fifth Clinical Institute of Shantou University Medical College, Shantou, People's Republic of China"
      ],
      "name": "Binyao Chen"
    },
    {
      "affiliations": [
        "Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou, Guangdong, China",
        "Fifth Clinical Institute of Shantou University Medical College, Shantou, People's Republic of China"
      ],
      "name": "Hongxi Wang"
    },
    {
      "affiliations": [
        "Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou, Guangdong, China",
        "Fifth Clinical Institute of Shantou University Medical College, Shantou, People's Republic of China"
      ],
      "name": "Jiao Jiang"
    },
    {
      "affiliations": [
        "Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou, Guangdong, China",
        "Fifth Clinical Institute of Shantou University Medical College, Shantou, People's Republic of China"
      ],
      "name": "Hailiu Chen"
    },
    {
      "affiliations": [
        "Queen's University Belfast, Centre for public health, Belfast, UK",
        "Orbis International, New York City, New York, USA",
        "Sun Yat-sen University, Zhongshan ophthalmic Center, Guangzhou, People's Republic of China"
      ],
      "name": "Nathan Congdon"
    },
    {
      "affiliations": [
        "Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou, Guangdong, China",
        "Fifth Clinical Institute of Shantou University Medical College, Shantou, People's Republic of China",
        "GuangDong Engineering Technology Research Center of Precision Treatment for Ocular Diseases, Shantou, People's Republic of China",
        "Guangdong Engineering Research Center of Intelligent Diagnosis and Treatment for Ocular Diseases, Shantou, People's Republic of China",
        "Shantou Key Laboratory of Ocular Disease Prevention,Treatment, and Research, Shantou, People's Republic of China"
      ],
      "name": "Kunliang Qiu"
    }
  ],
  "title": "Global temporal trends of DR-related blindness and vision loss from 1990 to 2021: an age-period-cohort analysis of the contributions of type 1 and type 2 diabetes",
  "uid": "72b0c935-9d2e-50da-8eee-c0aa498f5436"
}