gms | German Medical Science

104th DOG Annual Meeting

21. - 24.09.2006, Berlin

Diabetic retinopathy including macular edema in Germany: epidemiology and burden of disease

Meeting Abstract

  • M. Happich - Eli Lilly and Company
  • P. Falkenstein - Kendle International Inc., Munich, Germany
  • U. Reitberger - Kendle International Inc., Munich, Germany
  • F. Eichmann - Kendle International Inc., Munich, Germany
  • J. Clouth - Eli Lilly and Company

Deutsche Ophthalmologische Gesellschaft e.V.. 104. Jahrestagung der Deutschen Ophthalmologischen Gesellschaft (DOG). Berlin, 21.-24.09.2006. Düsseldorf, Köln: German Medical Science; 2006. Doc06dogSO.04.03

The electronic version of this article is the complete one and can be found online at:

Published: September 18, 2006

© 2006 Happich et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.




Diabetic Retinopathy (DR) and macular edema (ME) are the most common causes of acquired blindness in working age adults in Germany. Little is known about disease progression, the prevalence of DR/ME stages and the associated burden of disease.


An epidemiological study in type 1 and type 2 diabetics (N=1412) was conducted in 2002 to assess the relative prevalence of different DR severity stages and ME. Published prevalence data for diabetes and DR/ME were combined with the study results to estimate overall prevalences for Germany. In a detailed observational pharmacoeconomic study (N=207) in patients with DR/ME, the burden of disease in terms of quality of life and costs of illness was evaluated.


Based on the epidemiological study results and published estimates of 7 mio. diabetics in Germany, approximately 2.45 mio. patients are suffering from DR and/or ME in Germany. 931,000 of them have mild and 490,000 patients moderate non-proliferative DR. Severe non-proliferative DR and proliferative DR concern 122,500 patients each and 808,500 patients have macular edema in addition to DR. Impaired (69% of patients) and blurred (55%) vision as predominant symptoms were reported across all stages of DR and increased with disease severity and with occurrence of ME. The burden of the disease with respect to the patients’ quality of life as assessed by the generic SF-12 physical component scale increased from mild (44.6) to severe non-proliferative retinopathy (41.9) and was lowest for proliferative retinopathy (38.0) and for macular edema combined with DR (34.1). Patients with DR and ME also exhibited low SF-12 mental health component scores (42.0); 11% described their current quality of life as “bad” while a total of about 70% expected their quality of life to be “very much better” or “much better” without eye problems, as rated on the disease-specific RetDQol. Based on the prevalence rates estimated in the epidemiological study and the results from the pharmacoeconomic observation, the financial burden of DR and ME from the societal perspective in Germany total 3.5 mrd. € per year.


DR and ME affect a large number of diabetes patients in Germany. The burden of the disease as reflected in the medical status and health-related quality of life severely decreases with increasing disease severity and progression. Therefore, special emphasis should be placed on avoiding the progression of DR.