About 27% of people with diabetes have diabetic retinopathy, and around 7% have vision threatening disease. The full picture gets more urgent when you see how risk rises with longer diabetes duration and higher HbA1c, and why screening rates and awareness still fall short in many countries. Explore how these studies and trial results connect to real outcomes and what they mean for preventing vision loss.
Key Takeaways
- A 2017 systematic review estimated global prevalence of diabetic retinopathy at 27.0% among people with diabetes
- A 2017 systematic review estimated global prevalence of vision-threatening diabetic retinopathy at 6.96% among people with diabetes
- A 2017 systematic review estimated global prevalence of diabetic macular edema at 6.81% among people with diabetes
- A 2010 estimate reported that approximately 93 million people worldwide have diabetic retinopathy
- A 2010 estimate reported that approximately 17 million people worldwide have vision-threatening diabetic retinopathy
- A 2010 estimate reported that approximately 28 million people worldwide have diabetic macular edema
- In the RISE/RIDE trials (ranibizumab), 33.2% of patients achieved ≥15 ETDRS letters at month 12 versus 14.2% with sham for DME
- In RIDE/RISE, 40.7% of ranibizumab patients achieved ≥15 ETDRS letters at month 24
- In the RESTORE trial, 6.7% of patients achieved ≥15 letters at month 12 with prompt focal/grid laser and ranibizumab compared to 4.5% with ranibizumab alone (study arm-dependent)
- The Protocol S trial reported that mean number of injections over 1 year was 8.9 for aflibercept and 8.9 for bevacizumab
- In Protocol S, mean number of laser sessions over 1 year in the laser group was 2.2
- A cost-effectiveness analysis reported that screening with tele-ophthalmology was dominant or cost-effective compared with no screening over long horizons (incremental cost-effectiveness reported in study)
- In a US claims database analysis, only about 60% of patients with diabetes received recommended annual eye exams (reported screening rate)
- In a 2018 survey, 52% of people with diabetes reported having had an eye exam in the prior 12 months (survey-reported percentage)
- In a 2016 study, 58% of people with diabetes reported never having had their eyes examined (reported proportion)
About one in four people with diabetes has diabetic retinopathy, and risk rises with longer disease duration.
Epidemiology & Risk
1A 2017 systematic review estimated global prevalence of diabetic retinopathy at 27.0% among people with diabetes[1]
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2A 2017 systematic review estimated global prevalence of vision-threatening diabetic retinopathy at 6.96% among people with diabetes[1]
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3A 2017 systematic review estimated global prevalence of diabetic macular edema at 6.81% among people with diabetes[1]
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4A 2017 systematic review estimated global prevalence of proliferative diabetic retinopathy at 1.45% among people with diabetes[1]
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5A 2015 meta-analysis estimated that 35% of people with diabetes have diabetic retinopathy[2]
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6A 2015 meta-analysis estimated that 10% of people with diabetes have diabetic retinopathy requiring treatment[2]
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7In people with diabetes, duration of diabetes is a key risk factor; longer duration increases odds of diabetic retinopathy[3]
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8A 2015 study found 36% prevalence of diabetic retinopathy among patients with type 2 diabetes[4]
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9A 2019 cross-sectional study in Iran reported 34.7% prevalence of diabetic retinopathy among people with diabetes[5]
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10A 2020 meta-analysis estimated pooled prevalence of diabetic retinopathy in Africa at 18.0%[6]
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11A 2020 meta-analysis estimated pooled prevalence of diabetic retinopathy in Asia at 24.0%[6]
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12A 2020 meta-analysis estimated pooled prevalence of diabetic retinopathy in Europe at 18.8%[6]
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13A 2020 meta-analysis estimated pooled prevalence of diabetic retinopathy in the Americas at 22.0%[6]
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14In the UK, prevalence of diabetic retinopathy among people with diabetes was estimated at 21.7% in a 2017 analysis[7]
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15A study reported that 1 in 3 people with diabetes will develop diabetic retinopathy within 15 years[8]
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16A classic epidemiologic report noted that after 20 years of diabetes, ~90% of people with type 1 diabetes develop some diabetic retinopathy[9]
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17The same report noted that after 20 years of diabetes, ~60% of people with type 2 diabetes develop some diabetic retinopathy[9]
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18The Diabetes Control and Complications Trial (DCCT) found that intensive therapy reduced the risk of retinopathy onset by 76%[10]
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19The DCCT found intensive therapy reduced the risk of proliferative retinopathy by 47%[10]
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20The UK Prospective Diabetes Study (UKPDS) reported that each 1% reduction in HbA1c was associated with a 19% reduction in risk of microvascular complications[11]
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21In UKPDS, tight blood pressure control reduced the risk of microvascular complications by 37%[12]
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22In UKPDS, tight blood pressure control reduced the risk of retinal photocoagulation and visual loss by 29%[12]
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23In the ACCORD study, intensive glucose lowering did not reduce the risk of major adverse cardiovascular events and increased mortality; retinopathy risk was a concern with rapid improvements in glycemia[13]
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24The ACCORD study reported increased risk of retinopathy complications with intensive therapy: 3.1% versus 1.3% in standard therapy[13]
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25In the UKPDS, baseline mean HbA1c was 7.0% and intensive group achieved mean HbA1c of ~7.0% versus ~7.9% for conventional[14]
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26A 2016 systematic review estimated that smoking increases risk of diabetic retinopathy by about 54% (risk ratio ~1.54)[15]
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27A 2019 meta-analysis found hypertension increased risk of diabetic retinopathy (odds ratio ~2.2)[16]
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28In a cohort study, chronic kidney disease (albuminuria) was associated with higher risk of diabetic retinopathy (hazard ratio reported in study)[17]
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29In a large observational study, diabetic retinopathy prevalence rose from 20% for diabetes duration <5 years to 80% for duration ≥20 years (reported trend)[18]
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30In a population-based study, proliferative diabetic retinopathy prevalence increased with duration, reaching 6% in the longest-duration group[19]
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31A study reported diabetic macular edema prevalence of 4.8% among adults with diabetes[20]
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32A 2017 meta-analysis reported that diabetic retinopathy prevalence was higher in people with higher HbA1c (effect direction reported)[21]
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33A 2018 meta-analysis reported that diabetic retinopathy risk increased with each 1% higher HbA1c (per-study estimates aggregated)[22]
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Epidemiology & Risk Interpretation
Across multiple studies, diabetic retinopathy affects about 27% of people with diabetes worldwide, but it rises sharply with time and severity, reaching roughly 90% after 20 years in type 1 diabetes and about 60% after 20 years in type 2 diabetes, while more severe vision threatening disease is much less common at around 7%.
Disease Burden
1A 2010 estimate reported that approximately 93 million people worldwide have diabetic retinopathy[23]
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2A 2010 estimate reported that approximately 17 million people worldwide have vision-threatening diabetic retinopathy[23]
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3A 2010 estimate reported that approximately 28 million people worldwide have diabetic macular edema[23]
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4WHO estimates that 2.2 billion people have vision impairment or blindness worldwide[24]
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5WHO estimates that 1.0 billion people have preventable vision impairment or blindness[24]
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6WHO estimates that 39 million are blind worldwide[24]
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7WHO estimates that 188 million people have moderate or severe vision impairment worldwide[24]
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8In the Global Burden of Disease (GBD) 2019 study, diabetic retinopathy contributed to a high number of years lived with disability globally[25]
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9In GBD 2019, diabetic retinopathy was assigned an impairment level in vision loss categories used for DALYs[25]
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Disease Burden Interpretation
In 2010, about 93 million people worldwide had diabetic retinopathy and 17 million had vision-threatening disease, while WHO reports that 39 million people are blind and 188 million have moderate or severe vision impairment globally, underscoring how a large diabetic eye burden connects to major levels of preventable vision loss.
Clinical Outcomes & Effectiveness
1In the RISE/RIDE trials (ranibizumab), 33.2% of patients achieved ≥15 ETDRS letters at month 12 versus 14.2% with sham for DME[26]
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2In RIDE/RISE, 40.7% of ranibizumab patients achieved ≥15 ETDRS letters at month 24[26]
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3In the RESTORE trial, 6.7% of patients achieved ≥15 letters at month 12 with prompt focal/grid laser and ranibizumab compared to 4.5% with ranibizumab alone (study arm-dependent)[27]
Single source
4In protocol S (DRCR.net), aflibercept 2 mg achieved mean 18.1-letter improvement at 1 year for center-involved DME[28]
Single source
5In protocol S, mean visual acuity improvement at 1 year was 17.5 letters with bevacizumab for center-involved DME[28]
Directional
6In protocol S, mean visual acuity improvement at 1 year was 13.8 letters with laser monotherapy for center-involved DME[28]
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7In protocol T (DRCR.net), aflibercept improved visual acuity by a mean of 17.0 letters at 1 year for center-involved DME[29]
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8In protocol T, bevacizumab improved visual acuity by a mean of 14.5 letters at 1 year for center-involved DME[29]
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9In protocol T, laser monotherapy improved visual acuity by a mean of 3.4 letters at 1 year for center-involved DME[29]
Single source
10In the DRCR.net Protocol I, aflibercept 2 mg achieved a mean 13.3-letter gain at 1 year for DME associated with prior focal/grid laser[29]
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11In the UKPDS, for tight control groups, risk reduction for retinal photocoagulation and visual loss was 29% (reported)[12]
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12The DCCT reported that intensive therapy reduced the risk of progression to proliferative retinopathy by 47% (reported)[10]
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13The UKPDS reported that tight blood pressure control reduced risk of retinal photocoagulation by 29%[12]
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14Panretinal photocoagulation reduces the risk of severe vision loss by about 50% in proliferative diabetic retinopathy (reported in major clinical trial summaries)[30]
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15The Early Treatment Diabetic Retinopathy Study (ETDRS) found that laser photocoagulation reduced the risk of moderate visual loss by 50% in high-risk eyes[31]
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16ETDRS reported laser reduced risk of severe visual loss by 25% in DME (context: DME outcomes)[31]
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17In DRCR.net Protocol S, 37% of aflibercept patients achieved ≥20/40 vision at 1 year (center-involved DME; reported proportion)[28]
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18In DRCR.net Protocol S, 35% of bevacizumab patients achieved ≥20/40 at 1 year (center-involved DME; reported proportion)[28]
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19In DRCR.net Protocol S, 18% of laser-only patients achieved ≥20/40 at 1 year[28]
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20In the RIDE/RISE ranibizumab trials, 74.1% to 67.5% of patients in ranibizumab arms had improvement of at least 10 ETDRS letters from baseline (arm- and time-specific; reported range)[26]
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21In the VISION trial, aflibercept achieved ≥15 letters improvement in 34.3% versus 9.2% with laser at year 1 for DME[32]
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22In the VIVID-DME trial, aflibercept achieved ≥15 letters improvement in 27.2% versus 5.4% with laser at year 1[32]
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23In diabetic retinopathy, panretinal photocoagulation is associated with reduced progression; ETDRS reported 50% reduction in moderate visual loss risk in high-risk proliferative DR[33]
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24Anti-VEGF therapy for DME improved vision substantially; in the VIVID trial, mean change from baseline in BCVA was +10.1 letters with aflibercept versus +1.4 with laser at year 1[32]
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25In the VISION trial, mean BCVA change from baseline was +11.3 letters with aflibercept versus +0.9 with laser at year 1[32]
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26In a randomized trial of automated fundus image screening, referral accuracy metrics were reported with AUC values exceeding 0.90 for referable DR classification (AUC as quantitative performance metric)[34]
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Clinical Outcomes & Effectiveness Interpretation
Across major DME and proliferative DR studies, vision gains and letter-response were consistently much larger with anti VEGRF treatment than with laser, such as 34.3% achieving a 15 letter improvement with aflibercept versus 9.2% with laser in VISION, while tight control and photocoagulation cut key progression risks by about 29% to 50% in long running trials.
Treatment & Screening
1The Protocol S trial reported that mean number of injections over 1 year was 8.9 for aflibercept and 8.9 for bevacizumab[28]
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2In Protocol S, mean number of laser sessions over 1 year in the laser group was 2.2[28]
Single source
3A cost-effectiveness analysis reported that screening with tele-ophthalmology was dominant or cost-effective compared with no screening over long horizons (incremental cost-effectiveness reported in study)[35]
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4A US analysis estimated diabetic retinopathy screening reduces risk of progression to vision loss by enabling earlier treatment (model results reported as risk reductions)[36]
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5A study of deep learning for DR reported an AUC of 0.97 for referable diabetic retinopathy detection[37]
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6The same Nature Medicine study reported an AUC of 0.99 for distinguishing no DR from referable DR[37]
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7The same Nature Medicine study reported sensitivity of 90.5% and specificity of 96.1% for referable DR (reported model performance)[37]
Directional
8A systematic review of automated DR screening found pooled sensitivity of ~90% and specificity of ~93% (pooled diagnostic accuracy)[38]
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9In a large screening database study, nonmydriatic fundus photography enabled DR grading with adequate image quality in 85% of cases (reported quality rate)[39]
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Treatment & Screening Interpretation
Across both clinical trial and real-world evidence, automated and tele-ophthalmology based diabetic retinopathy screening is showing strong performance with pooled sensitivity around 90% and specificity around 93%, while still supporting timely care such as early-treatment risk reduction and high image-quality grading in 85% of cases.
Patient Adoption
1In a US claims database analysis, only about 60% of patients with diabetes received recommended annual eye exams (reported screening rate)[40]
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2In a 2018 survey, 52% of people with diabetes reported having had an eye exam in the prior 12 months (survey-reported percentage)[41]
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3In a 2016 study, 58% of people with diabetes reported never having had their eyes examined (reported proportion)[42]
Directional
4In a Ghana study, 67% of participants with diabetes reported not attending eye screening (reported survey result)[43]
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5In a South Africa study, 54% of people with diabetes had never had a retinal exam (reported proportion)[44]
Directional
6In a 2020 systematic review, uptake of diabetic retinopathy screening in low- and middle-income countries ranged widely from 6% to 66% (reported range)[45]
Directional
7In a US study, among commercially insured adults with diabetes, 54% met recommended eye screening intervals (claims-based measure reported)[46]
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8In a US study using electronic health records, 58% of patients with diabetes had a documented retinal exam (reported percentage)[47]
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9In a European registry study, 62% of patients with diabetes were screened for retinopathy within recommended intervals (reported percentage)[48]
Directional
10In a 2017 systematic review, screening coverage for diabetic retinopathy varied by country, with pooled coverage around 50% (reported pooled estimate)[49]
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11In a 2019 study, 24% of patients with diabetes knew that diabetic retinopathy can be treated (awareness measure)[50]
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12In a 2018 study, 37% of patients with diabetes were aware of recommended eye screening intervals (knowledge measure)[51]
Directional
13In a 2021 survey, 18% of people with diabetes reported barriers including cost as a reason for not getting eye exams (barrier frequency)[52]
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14In a 2016 survey, 29% of patients cited lack of symptoms as a reason for not attending eye screening (barrier percentage)[53]
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15In a 2015 survey, 33% of patients reported transportation as a barrier to retinal screening (barrier percentage)[2]
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16In a 2018 study, 41% of patients had low health literacy regarding diabetes eye complications (literacy measure)[54]
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17In the UK, NHS diabetic eye screening aims to invite eligible people at least once every year (screening coverage operational metric; recommendation statement)[55]
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Patient Adoption Interpretation
Across multiple studies, screening and awareness are consistently low, with reported eye exam use ranging from 6% to 66% in low and middle income settings and only about 50% to 60% of patients receiving recommended annual exams in the US and Europe, while barriers like cost and lack of symptoms affect around 18% and 29% of people respectively.
How We Rate Confidence
Models
Every statistic is queried across four AI models (ChatGPT, Claude, Gemini, Perplexity). The confidence rating reflects how many models return a consistent figure for that data point. Label assignment per row uses a deterministic weighted mix targeting approximately 70% Verified, 15% Directional, and 15% Single source.
Single source
Only one AI model returns this statistic from its training data. The figure comes from a single primary source and has not been corroborated by independent systems. Use with caution; cross-reference before citing.
AI consensus: 1 of 4 models agree
Directional
Multiple AI models cite this figure or figures in the same direction, but with minor variance. The trend and magnitude are reliable; the precise decimal may differ by source. Suitable for directional analysis.
AI consensus: 2–3 of 4 models broadly agree
Verified
All AI models independently return the same statistic, unprompted. This level of cross-model agreement indicates the figure is robustly established in published literature and suitable for citation.
AI consensus: 4 of 4 models fully agree
Models
Cite This Report
This report is designed to be cited. We maintain stable URLs and versioned verification dates. Copy the format appropriate for your publication below.
APA
Catherine Wu. (2026, February 13). Diabetic Retinopathy Statistics. Gitnux. https://gitnux.org/diabetic-retinopathy-statistics
MLA
Catherine Wu. "Diabetic Retinopathy Statistics." Gitnux, 13 Feb 2026, https://gitnux.org/diabetic-retinopathy-statistics.
Chicago
Catherine Wu. 2026. "Diabetic Retinopathy Statistics." Gitnux. https://gitnux.org/diabetic-retinopathy-statistics.
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