Prevalence of Retinopathy in Prediabetic Populations: A Systematic Review and Meta-Analysis

Among the leading causes of vision impairment and blindness globally, diabetic retinopathy (DR) is one of the most important causes. There is increasing evidence of DR prevalence in the prediabetic population. This systematic review presents collective data on retinopathy in the prediabetic population. This review article aimed to estimate the reported prevalence of retinopathy in prediabetes, impaired glucose tolerance test (GTT) without diabetes mellitus, and the risk factors involved and to summarize it. Literature searches were done using the Web of Science, CINAHL, Google Scholar, Cochrane, EMBASE, and PubMed databases from inception to April 2023. Our search included the words prediabetes, DR, and risk factors. All searches were looked at for methodological quality and evidence. Thirty-one studies were included after the screening. Population-based data were used in 23 studies (82.1%). The prediabetic population screened was 10,539. The prevalence of retinopathy ranged between 0.3% and 20.9%, showing a median of 8.1% with an interquartile range (IQR) of 4.2-11%, showing great variance in estimates due to the use of different screening methods, methods used for retinopathy grading, and study populations. Several studies compared the population with normal GTT with impaired glucose tolerance (IGT) and inferred that there was a lower prevalence of retinopathy in the normal GTT population (3.0%, IQR 0.3-7.4%) than prediabetes (6.7%, IQR 1.9-10.1%). According to this data, a greater retinopathy prevalence was found in prediabetic populations.