{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T17:00:13Z","timestamp":1790269213515,"version":"4.1.0"},"reference-count":95,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T00:00:00Z","timestamp":1790208000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T00:00:00Z","timestamp":1790208000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Int Ophthalmol"],"DOI":"10.1007\/s10792-026-04282-6","type":"journal-article","created":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T14:35:57Z","timestamp":1790260557000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Magnitude, patterns, and determinant factors of diabetic macular edema among people with diabetes at Debre Markos Referral Hospital, Northwest Ethiopia, 2025: a hospital-based cross-sectional study"],"prefix":"10.1007","volume":"46","author":[{"given":"Melkamu","family":"Tilahun","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nibret Abebaw","family":"Yeneneh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megbar","family":"Dessalegn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adane","family":"Adugna","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed","family":"Jemal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haile","family":"Amha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yeshimareg Shita","family":"Mekete","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,24]]},"reference":[{"key":"4282_CR1","doi-asserted-by":"publisher","first-page":"97","DOI":"10.1007\/978-3-319-96157-6_3","volume-title":"Clinical strategies in the management of diabetic retinopathy: a step-by-step guide for ophthalmologists","author":"F Bandello","year":"2019","unstructured":"Bandello F, Lattanzio R, Zucchiatti I, Arrigo A, Battista M, Cicinelli MV (2019) Diabetic macular edema. In: Bandello F, Zarbin MA, Lattanzio R, Zucchiatti I (eds) Clinical strategies in the management of diabetic retinopathy: a step-by-step guide for ophthalmologists. Springer International Publishing, Cham, pp 97\u2013183"},{"issue":"1","key":"4282_CR2","first-page":"32","volume":"9","author":"PK Prabhakar","year":"2016","unstructured":"Prabhakar PK (2016) Pathophysiology of secondary complications of diabetes mellitus. Pathophysiology 9(1):32\u201336","journal-title":"Pathophysiology"},{"issue":"9","key":"4282_CR3","doi-asserted-by":"publisher","first-page":"2653","DOI":"10.2337\/diacare.26.9.2653","volume":"26","author":"TA Ciulla","year":"2003","unstructured":"Ciulla TA, Amador AG, Zinman B (2003) Diabetic retinopathy and diabetic macular edema: pathophysiology, screening, and novel therapies. Diabetes Care 26(9):2653\u20132664","journal-title":"Diabetes Care"},{"key":"4282_CR4","doi-asserted-by":"publisher","DOI":"10.1155\/2016\/2156273","author":"P Romero-Aroca","year":"2016","unstructured":"Romero-Aroca P, Baget-Bernaldiz M, Pareja-Rios A, Lopez-Galvez M, Navarro-Gil R, Verges R (2016) Diabetic macular edema pathophysiology: vasogenic versus inflammatory. J Diabetes Res. https:\/\/doi.org\/10.1155\/2016\/2156273","journal-title":"J Diabetes Res"},{"key":"4282_CR5","doi-asserted-by":"crossref","unstructured":"UK Prospective Diabetes Study (UKPDS) Group (1998) Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 38. Bmj 317(7160):703\u2013713.","DOI":"10.1136\/bmj.317.7160.703"},{"issue":"6","key":"4282_CR6","doi-asserted-by":"publisher","first-page":"689","DOI":"10.1038\/sj.eye.6700205","volume":"16","author":"TA Chowdhury","year":"2002","unstructured":"Chowdhury TA, Hopkins D, Dodson PM, Vafidis GC (2002) The role of serum lipids in exudative diabetic maculopathy: is there a place for lipid-lowering therapy? Eye 16(6):689\u2013693","journal-title":"Eye"},{"issue":"2","key":"4282_CR7","doi-asserted-by":"publisher","first-page":"244","DOI":"10.1001\/archopht.1989.01070010250031","volume":"107","author":"R Klein","year":"1989","unstructured":"Klein R (1989) The Wisconsin epidemiologic study of diabetic retinopathy. Arch Ophthalmol 107(2):244","journal-title":"Arch Ophthalmol"},{"key":"4282_CR8","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2023.1128811","volume":"10","author":"CD Haydinger","year":"2023","unstructured":"Haydinger CD, Ferreira LB, Williams KA, Smith JR (2023) Mechanisms of macular edema. Front Med 10:1128811","journal-title":"Front Med"},{"key":"4282_CR9","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1016\/j.preteyeres.2017.10.006","volume":"63","author":"A Daruich","year":"2018","unstructured":"Daruich A, Matet A, Moulin A, Kowalczuk L, Nicolas M, Sellam A et al (2018) Mechanisms of macular edema: beyond the surface. Prog Retin Eye Res 63:20\u201368","journal-title":"Prog Retin Eye Res"},{"issue":"2","key":"4282_CR10","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1016\/S2213-8587(16)30052-3","volume":"5","author":"GS Tan","year":"2017","unstructured":"Tan GS, Cheung N, Simo R, Cheung GC, Wong TY (2017) Diabetic macular oedema. Lancet Diabetes Endocrinol 5(2):143\u2013155","journal-title":"Lancet Diabetes Endocrinol"},{"issue":"5","key":"4282_CR11","doi-asserted-by":"publisher","first-page":"2160","DOI":"10.1167\/iovs.10-6518","volume":"52","author":"H-Z Xu","year":"2011","unstructured":"Xu H-Z, Le Y-Z (2011) Significance of outer blood\u2013retina barrier breakdown in diabetes and ischemia. Invest Ophthalmol Vis Sci 52(5):2160\u20132164","journal-title":"Invest Ophthalmol Vis Sci"},{"issue":"58","key":"4282_CR12","doi-asserted-by":"publisher","first-page":"102","DOI":"10.1159\/000455277","volume":"58","author":"F Bandello","year":"2017","unstructured":"Bandello F, Battaglia Parodi M, Lanzetta P, Loewenstein A, Massin P, Menchini F et al (2017) Diabetic macular edema. Dev Ophthalmol 58(58):102\u2013138","journal-title":"Dev Ophthalmol"},{"key":"4282_CR13","doi-asserted-by":"crossref","unstructured":"Cunha-Vaz J. The blood-retinal barrier in retinal disease. Eur Ophthalmic Rev. 2009;3(2):105\u2013108. https:\/\/doi.org\/10.17925\/eor.2009.03.02.105","DOI":"10.17925\/EOR.2009.03.02.105"},{"key":"4282_CR14","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1007\/978-981-19-7307-9_2","volume-title":"Diabetic macular edema","author":"AP Cabrera","year":"2022","unstructured":"Cabrera AP, Wolinsky EL, Mankad RN, Monickaraj F, Das A. Pathophysiology of diabetic macular edema. Diabetic macular edema. Singapore: Springer Nature Singapore; 2022. p. 7\u201325. doi:10.1007\/978-981-19-7307-9_2.\u00a0\u00a0"},{"issue":"3","key":"4282_CR15","doi-asserted-by":"publisher","first-page":"236","DOI":"10.1007\/BF00691095","volume":"72","author":"I Klatzo","year":"1987","unstructured":"Klatzo I (1987) Pathophysiological aspects of brain edema. Acta Neuropathol 72(3):236\u2013239","journal-title":"Acta Neuropathol"},{"issue":"6","key":"4282_CR16","doi-asserted-by":"publisher","first-page":"905","DOI":"10.1111\/cxo.13061","volume":"103","author":"A Edgar","year":"2020","unstructured":"Edgar A, Ward J, Woods C (2020) Optical coherence tomography in the assessment of simultaneous macula oedema and papilloedema. Clin Exp Optom 103(6):905\u2013907","journal-title":"Clin Exp Optom"},{"issue":"3","key":"4282_CR17","first-page":"133","volume":"59","author":"O Musat","year":"2015","unstructured":"Musat O, Cernat C, Labib M, Gheorghe A, Toma O, Zamfir M et al (2015) Diabetic macular edema. Roman J Ophthalmol 59(3):133","journal-title":"Roman J Ophthalmol"},{"key":"4282_CR18","doi-asserted-by":"publisher","DOI":"10.1155\/2014\/191847","author":"E Badar\u00f3","year":"2014","unstructured":"Badar\u00f3 E, Novais E, Prodocimo LM, Sallum JMF (2014) Spectral\u2010domain optical coherence tomography for macular edema. Sci World J. https:\/\/doi.org\/10.1155\/2014\/191847","journal-title":"Sci World J"},{"issue":"6","key":"4282_CR19","doi-asserted-by":"publisher","first-page":"151","DOI":"10.1177\/2042018813512360","volume":"4","author":"DS Boyer","year":"2013","unstructured":"Boyer DS, Hopkins JJ, Sorof J, Ehrlich JS (2013) Anti-vascular endothelial growth factor therapy for diabetic macular edema. Ther Adv Endocrinol Metab 4(6):151\u2013169","journal-title":"Ther Adv Endocrinol Metab"},{"issue":"3","key":"4282_CR20","doi-asserted-by":"publisher","first-page":"505","DOI":"10.1016\/j.ajo.2013.11.012","volume":"157","author":"P Mitchell","year":"2014","unstructured":"Mitchell P, Wong TY, Diabetic Macular Edema Treatment Guidelines Working Group (2014) Management paradigms for diabetic macular edema. Am J Ophthalmol 157(3):505\u201313.e8","journal-title":"Am J Ophthalmol"},{"issue":"5","key":"4282_CR21","doi-asserted-by":"publisher","first-page":"766","DOI":"10.1016\/S0161-6420(13)38011-7","volume":"98","author":"Early Treatment Diabetic Retinopathy Study Research Group","year":"1991","unstructured":"Early Treatment Diabetic Retinopathy Study Research Group (1991) Early photocoagulation for diabetic retinopathy: ETDRS report number 9. Ophthalmology 98(5):766\u2013785","journal-title":"Ophthalmology"},{"issue":"1","key":"4282_CR22","doi-asserted-by":"publisher","DOI":"10.1186\/s40662-015-0026-2","volume":"2","author":"R Lee","year":"2015","unstructured":"Lee R, Wong TY, Sabanayagam C (2015) Epidemiology of diabetic retinopathy, diabetic macular edema and related vision loss. Eye Vis 2(1):17","journal-title":"Eye Vis"},{"issue":"4","key":"4282_CR23","doi-asserted-by":"publisher","first-page":"1244","DOI":"10.1016\/j.survophthal.2022.01.009","volume":"67","author":"JH Im","year":"2022","unstructured":"Im JH, Jin Y-P, Chow R, Yan P (2022) Prevalence of diabetic macular edema based on optical coherence tomography in people with diabetes: a systematic review and meta-analysis. Surv Ophthalmol 67(4):1244\u20131251","journal-title":"Surv Ophthalmol"},{"issue":"Suppl. 1","key":"4282_CR24","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1159\/000337156","volume":"227","author":"GE Lang","year":"2012","unstructured":"Lang GE (2012) Diabetic macular edema. Ophthalmologica 227(Suppl. 1):21\u201329","journal-title":"Ophthalmologica"},{"issue":"4","key":"4282_CR25","doi-asserted-by":"publisher","first-page":"346","DOI":"10.1007\/s11892-012-0283-6","volume":"12","author":"J Ding","year":"2012","unstructured":"Ding J, Wong TY (2012) Current epidemiology of diabetic retinopathy and diabetic macular edema. Curr Diab Rep 12(4):346\u2013354","journal-title":"Curr Diab Rep"},{"key":"4282_CR26","doi-asserted-by":"crossref","unstructured":"Kabtu E, Tsegaw A (2022) Prevalence of diabetic macular edema and risk factors among diabetic patients at the university of gondar tertiary eye care and training center, north west ethiopia. medRxiv 2022.04. 13.22273816.","DOI":"10.1101\/2022.04.13.22273816"},{"issue":"1","key":"4282_CR27","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-026-53165-4","volume":"16","author":"MB Simegn","year":"2026","unstructured":"Simegn MB, Feleke HG, Mengie MG, Gebey DM, Bitewa MD, Abneh AA et al (2026) Incidence and predictors of diabetic retinopathy among patients with type 2 diabetes and hypertension: a 10-year retrospective follow-up study. Sci Rep 16(1):22225","journal-title":"Sci Rep"},{"issue":"5","key":"4282_CR28","doi-asserted-by":"publisher","first-page":"649","DOI":"10.1016\/j.ajo.2008.07.013","volume":"146","author":"DJ Browning","year":"2008","unstructured":"Browning DJ, Altaweel MM, Bressler NM, Bressler SB, Scott IU, Network DRCR (2008) Diabetic macular edema: what is focal and what is diffuse? Am J Ophthalmol 146(5):649-655.e6","journal-title":"Am J Ophthalmol"},{"issue":"5","key":"4282_CR29","doi-asserted-by":"publisher","first-page":"786","DOI":"10.1016\/S0161-6420(13)38012-9","volume":"98","author":"Early Treatment Diabetic Retinopathy Study Research Group","year":"1991","unstructured":"Early Treatment Diabetic Retinopathy Study Research Group (1991) Grading diabetic retinopathy from stereoscopic color fundus photographs\u2014an extension of the modified Airlie House classification: ETDRS report number 10. Ophthalmology 98(5):786\u2013806","journal-title":"Ophthalmology"},{"key":"4282_CR30","unstructured":"World Health Organization (2003) Consultation on development of standards for characterization of vision loss and visual functioning. WHO Prevention of Blindness & Deafness"},{"issue":"9","key":"4282_CR31","doi-asserted-by":"publisher","first-page":"977","DOI":"10.1136\/jcp.2007.054304","volume":"61","author":"E Kilpatrick","year":"2008","unstructured":"Kilpatrick E (2008) Haemoglobin A1c in the diagnosis and monitoring of diabetes mellitus. J Clin Pathol 61(9):977\u2013982","journal-title":"J Clin Pathol"},{"key":"4282_CR32","doi-asserted-by":"crossref","unstructured":"National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (2001) Executive summary of the third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III). JAMA 285(19):2486\u20132497","DOI":"10.1001\/jama.285.19.2486"},{"key":"4282_CR33","volume-title":"StatPearls [Internet]","author":"N Pappan","year":"2024","unstructured":"Pappan N, Awosika A, Rehman A (2024) Dyslipidemia. StatPearls [Internet]. StatPearls Publishing, Treasure Island (FL)"},{"key":"4282_CR34","unstructured":"Bhagat N, Zarbin MA, Mukkamala L (2014) Diabetic macular edema. Am Acad Ophthalmol"},{"key":"4282_CR35","doi-asserted-by":"publisher","DOI":"10.1186\/1751-0473-3-17","volume":"3","author":"Z Bursac","year":"2008","unstructured":"Bursac Z, Gauss CH, Williams DK, Hosmer DW (2008) Purposeful selection of variables in logistic regression. Source Code Biol Med 3:17","journal-title":"Source Code Biol Med"},{"key":"4282_CR36","volume-title":"StatPearls [Internet]","author":"C Duphare","year":"2023","unstructured":"Duphare C, Desai K, Gupta P, Patel BC (2023) Diabetic macular edema. StatPearls [Internet]. StatPearls Publishing"},{"issue":"4","key":"4282_CR37","doi-asserted-by":"publisher","first-page":"687","DOI":"10.2337\/dc22-1834","volume":"46","author":"EA Lundeen","year":"2023","unstructured":"Lundeen EA, Kim M, Rein DB, Wittenborn JS, Saaddine J, Ehrlich JR et al (2023) Trends in the prevalence and treatment of diabetic macular edema and vision-threatening diabetic retinopathy among commercially insured adults aged <65 years. Diabetes Care 46(4):687\u2013696","journal-title":"Diabetes Care"},{"issue":"2","key":"4282_CR38","doi-asserted-by":"publisher","first-page":"315","DOI":"10.1177\/1120672119830578","volume":"30","author":"G Panozzo","year":"2020","unstructured":"Panozzo G, Staurenghi G, Dalla Mura G, Giannarelli D, Alessio G, Alongi S et al (2020) Prevalence of diabetes and diabetic macular edema in patients undergoing senile cataract surgery in Italy: the DIabetes and CATaract study. Eur J Ophthalmol 30(2):315\u2013320","journal-title":"Eur J Ophthalmol"},{"issue":"3","key":"4282_CR39","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2024-088507","volume":"15","author":"AF Shumye","year":"2023","unstructured":"Shumye AF, Tegegne MM, Bekele MM, Woredekal AT, Eticha BL (2023) Burden of diabetic macular oedema and its associated factors among adult patients with diabetes attending comprehensive specialised hospitals in Northwest Ethiopia, 2023: a multicentre cross-sectional study. BMJ Open 15(3):e088507","journal-title":"BMJ Open"},{"issue":"1","key":"4282_CR40","first-page":"159167","volume":"2012","author":"RJ Petrella","year":"2012","unstructured":"Petrella RJ, Blouin J, Davies B, Barbeau M (2012) Prevalence, demographics, and treatment characteristics of visual impairment due to diabetic macular edema in a representative Canadian cohort. Journal of Ophthalmology. 2012(1):159167","journal-title":"Journal of Ophthalmology."},{"issue":"1","key":"4282_CR41","doi-asserted-by":"publisher","DOI":"10.1186\/s12886-018-0753-y","volume":"18","author":"D Acan","year":"2018","unstructured":"Acan D, Calan M, Er D, Arkan T, Kocak N, Bayraktar F et al (2018) The prevalence and systemic risk factors of diabetic macular edema: a cross-sectional study from Turkey. BMC Ophthalmol 18(1):91","journal-title":"BMC Ophthalmol"},{"issue":"11","key":"4282_CR42","doi-asserted-by":"publisher","first-page":"13891","DOI":"10.18535\/jmscr\/v4i11.63","volume":"4","author":"L Singh","year":"2016","unstructured":"Singh L, Nigam B, Pathak K (2016) Prevalence and pattern of macular edema in diabetes. JMSCR 4(11):13891\u201313897","journal-title":"JMSCR"},{"issue":"3","key":"4282_CR43","doi-asserted-by":"publisher","first-page":"141","DOI":"10.1159\/000443972","volume":"235","author":"EM Webb","year":"2016","unstructured":"Webb EM, Rheeder P, Roux P (2016) Screening in primary care for diabetic retinopathy, maculopathy and visual loss in South Africa. Ophthalmologica 235(3):141\u2013149","journal-title":"Ophthalmologica"},{"issue":"4","key":"4282_CR44","doi-asserted-by":"publisher","DOI":"10.3390\/medicina56040164","volume":"56","author":"W Matuszewski","year":"2020","unstructured":"Matuszewski W, Baranowska-Jurkun A, Stefanowicz-Rutkowska MM, Modzelewski R, Pieczy\u0144ski J, Bandurska-Stankiewicz E (2020) Prevalence of diabetic retinopathy in type 1 and type 2 diabetes mellitus patients in North-East Poland. Medicina (B Aires) 56(4):164","journal-title":"Medicina (B Aires)"},{"issue":"3","key":"4282_CR45","doi-asserted-by":"publisher","first-page":"169","DOI":"10.3109\/09286586.2014.903982","volume":"21","author":"W Mathenge","year":"2014","unstructured":"Mathenge W, Bastawrous A, Peto T, Leung I, Yorston D, Foster A et al (2014) Prevalence and correlates of diabetic retinopathy in a population-based survey of older people in Nakuru, Kenya. Ophthalmic Epidemiol 21(3):169\u2013177","journal-title":"Ophthalmic Epidemiol"},{"key":"4282_CR46","doi-asserted-by":"crossref","unstructured":"Nadege M, Makupa W, Kisanga M. Proportion, patterns and factors associated with diabetic macular edema among diabetes type 2 patients attending KCMC Hospital 2023\u20132024. medRxiv. 2025:2025.06. 27.25330425.","DOI":"10.1101\/2025.06.27.25330425"},{"issue":"20","key":"4282_CR47","doi-asserted-by":"publisher","DOI":"10.3390\/jcm11206169","volume":"11","author":"R Amjad","year":"2022","unstructured":"Amjad R, Lee C-A, Farooqi HMU, Khan H, Paeng D-G (2022) Choroidal thickness in different patterns of diabetic macular edema. J Clin Med 11(20):6169","journal-title":"J Clin Med"},{"issue":"4","key":"4282_CR48","doi-asserted-by":"publisher","first-page":"766","DOI":"10.1016\/j.ophtha.2009.09.005","volume":"117","author":"R Raman","year":"2010","unstructured":"Raman R, Rani PK, Kulothungan V, Rachepalle SR, Kumaramanickavel G, Sharma T (2010) Influence of serum lipids on clinically significant versus nonclinically significant macular edema: SN-DREAMS Report number 13. Ophthalmology 117(4):766\u2013772","journal-title":"Ophthalmology"},{"issue":"9","key":"4282_CR49","doi-asserted-by":"publisher","first-page":"875","DOI":"10.1111\/ceo.12338","volume":"42","author":"G Kaidonis","year":"2014","unstructured":"Kaidonis G, Mills RA, Landers J, Lake SR, Burdon KP, Craig JE (2014) Review of the prevalence of diabetic retinopathy in Indigenous Australians. Clin Exp Ophthalmol 42(9):875\u2013882","journal-title":"Clin Exp Ophthalmol"},{"issue":"1","key":"4282_CR50","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2415-9-12","volume":"9","author":"MA Javadi","year":"2009","unstructured":"Javadi MA, Katibeh M, Rafati N, Dehghan MH, Zayeri F, Yaseri M et al (2009) Prevalence of diabetic retinopathy in Tehran province: a population-based study. BMC Ophthalmol 9(1):12","journal-title":"BMC Ophthalmol"},{"issue":"2","key":"4282_CR51","doi-asserted-by":"publisher","first-page":"311","DOI":"10.1016\/j.ophtha.2008.09.010","volume":"116","author":"R Raman","year":"2009","unstructured":"Raman R, Rani PK, Rachepalle SR, Gnanamoorthy P, Uthra S, Kumaramanickavel G et al (2009) Prevalence of diabetic retinopathy in India: Sankara Nethralaya diabetic retinopathy epidemiology and molecular genetics study report 2. Ophthalmology 116(2):311\u2013318","journal-title":"Ophthalmology"},{"issue":"10","key":"4282_CR52","doi-asserted-by":"publisher","first-page":"6827","DOI":"10.1167\/iovs.13-12654","volume":"54","author":"D Jee","year":"2008","unstructured":"Jee D, Lee WK, Kang S (2008) Prevalence and risk factors for diabetic retinopathy: the Korea National Health and Nutrition Examination Survey 2008\u20132011. Invest Ophthalmol Vis Sci 54(10):6827\u20136833","journal-title":"Invest Ophthalmol Vis Sci"},{"issue":"8","key":"4282_CR53","doi-asserted-by":"publisher","first-page":"986","DOI":"10.1038\/eye.2014.131","volume":"28","author":"R Kahloun","year":"2014","unstructured":"Kahloun R, Jelliti B, Zaouali S, Attia S, Ben Yahia S, Resnikoff S et al (2014) Prevalence and causes of visual impairment in diabetic patients in Tunisia, North Africa. Eye 28(8):986\u2013991","journal-title":"Eye"},{"key":"4282_CR54","doi-asserted-by":"publisher","first-page":"268","DOI":"10.1590\/S0104-42302009000300017","volume":"55","author":"JF Esteves","year":"2009","unstructured":"Esteves JF, Kramer CK, de Azevedo MJ, Stolz AP, Roggia MF, Larangeira A et al (2009) Prevalence of diabetic retinopathy in patients with type 1 diabetes mellitus. Rev Assoc Med Bras 55:268\u2013273","journal-title":"Rev Assoc Med Bras"},{"issue":"12","key":"4282_CR55","doi-asserted-by":"publisher","first-page":"1397","DOI":"10.1038\/eye.2013.196","volume":"27","author":"TD Keenan","year":"2013","unstructured":"Keenan TD, Johnston RL, Donachie PH, Sparrow JM, Stratton IM, Scanlon P (2013) United Kingdom National Ophthalmology Database Study: diabetic retinopathy; report 1: prevalence of centre-involving diabetic macular oedema and other grades of maculopathy and retinopathy in hospital eye services. Eye (Lond) 27(12):1397\u20131404","journal-title":"Eye (Lond)"},{"key":"4282_CR56","doi-asserted-by":"publisher","first-page":"3651","DOI":"10.2147\/OPTH.S275968","volume":"14","author":"A Moshfeghi","year":"2020","unstructured":"Moshfeghi A, Garmo V, Sheinson D, Ghanekar A, Abbass I (2020) Five-year patterns of diabetic retinopathy progression in US Clinical Practice. Clinical Ophthalmology (Auckland, NZ) 14:3651\u20133659","journal-title":"Clinical Ophthalmology (Auckland, NZ)"},{"issue":"3","key":"4282_CR57","doi-asserted-by":"publisher","first-page":"293","DOI":"10.1159\/000508335","volume":"65","author":"Y Wang","year":"2022","unstructured":"Wang Y, Lin Z, Zhai G, Ding XX, Wen L, Li D et al (2022) Prevalence of and risk factors for diabetic retinopathy and diabetic macular edema in patients with early- and late-onset diabetes mellitus. Ophthalmic Res 65(3):293\u2013299","journal-title":"Ophthalmic Res"},{"issue":"11","key":"4282_CR58","doi-asserted-by":"publisher","first-page":"1334","DOI":"10.1001\/jamaophthalmol.2014.2854","volume":"132","author":"R Varma","year":"2014","unstructured":"Varma R, Bressler NM, Doan QV, Gleeson M, Danese M, Bower JK et al (2014) Prevalence of and risk factors for diabetic macular edema in the United States. JAMA Ophthalmol 132(11):1334\u20131340","journal-title":"JAMA Ophthalmol"},{"issue":"2","key":"4282_CR59","doi-asserted-by":"publisher","first-page":"320","DOI":"10.18240\/ijo.2022.02.19","volume":"15","author":"Z Lin","year":"2022","unstructured":"Lin Z, Wang FH, Wen L, Wang Y, Li D, Ding XX et al (2022) Prevalence of and risk factors for diabetic macular edema in a northeastern Chinese population. Int J Ophthalmol 15(2):320\u2013326","journal-title":"Int J Ophthalmol"},{"issue":"3","key":"4282_CR60","doi-asserted-by":"publisher","DOI":"10.1016\/j.apjo.2024.100067","volume":"13","author":"G Zhang","year":"2024","unstructured":"Zhang G, Chen W, Chen H, Lin J, Cen L-P, Xie P et al (2024) Risk factors for diabetic retinopathy, diabetic macular edema, and sight-threatening diabetic retinopathy. Asia Pac J Ophthalmol 13(3):100067","journal-title":"Asia Pac J Ophthalmol"},{"issue":"3","key":"4282_CR61","doi-asserted-by":"publisher","first-page":"e7","DOI":"10.1016\/j.diabres.2013.12.043","volume":"103","author":"A Kajiwara","year":"2014","unstructured":"Kajiwara A, Miyagawa H, Saruwatari J, Kita A, Sakata M, Kawata Y et al (2014) Gender differences in the incidence and progression of diabetic retinopathy among Japanese patients with type 2 diabetes mellitus: a clinic-based retrospective longitudinal study. Diabetes Res Clin Pract 103(3):e7-10","journal-title":"Diabetes Res Clin Pract"},{"issue":"4","key":"4282_CR62","first-page":"224","volume":"6","author":"SA Rasoulinejad","year":"2015","unstructured":"Rasoulinejad SA, Hajian-Tilaki K, Mehdipour E (2015) Associated factors of diabetic retinopathy in patients referred to teaching hospitals in Babol. Caspian J Intern Med 6(4):224\u2013228","journal-title":"Caspian J Intern Med"},{"issue":"3","key":"4282_CR63","doi-asserted-by":"publisher","first-page":"417","DOI":"10.1111\/tmi.12652","volume":"21","author":"CR Cleland","year":"2016","unstructured":"Cleland CR, Burton MJ, Hall C, Hall A, Courtright P, Makupa WU et al (2016) Diabetic retinopathy in Tanzania: prevalence and risk factors at entry into a regional screening programme. Tropical medicine & International Health: TM & IH 21(3):417\u2013426","journal-title":"Tropical medicine & International Health: TM & IH"},{"issue":"Suppl 1","key":"4282_CR64","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1038\/s41433-020-0961-6","volume":"34","author":"WM Amoaku","year":"2020","unstructured":"Amoaku WM, Ghanchi F, Bailey C, Banerjee S, Banerjee S, Downey L et al (2020) Diabetic retinopathy and diabetic macular oedema pathways and management: UK Consensus Working Group. Eye (Lond) 34(Suppl 1):1\u201351","journal-title":"Eye (Lond)"},{"key":"4282_CR65","doi-asserted-by":"publisher","DOI":"10.1016\/j.preteyeres.2020.100903","volume":"82","author":"S Roy","year":"2021","unstructured":"Roy S, Kim D (2021) Retinal capillary basement membrane thickening: role in the pathogenesis of diabetic retinopathy. Prog Retin Eye Res 82:100903","journal-title":"Prog Retin Eye Res"},{"issue":"6865","key":"4282_CR66","doi-asserted-by":"publisher","first-page":"813","DOI":"10.1038\/414813a","volume":"414","author":"M Brownlee","year":"2001","unstructured":"Brownlee M (2001) Biochemistry and molecular cell biology of diabetic complications. Nature 414(6865):813\u2013820","journal-title":"Nature"},{"issue":"1","key":"4282_CR67","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1152\/physrev.00045.2011","volume":"93","author":"JM Forbes","year":"2013","unstructured":"Forbes JM, Cooper ME (2013) Mechanisms of diabetic complications. Physiol Rev 93(1):137\u2013188","journal-title":"Physiol Rev"},{"issue":"22","key":"4282_CR68","doi-asserted-by":"publisher","first-page":"1480","DOI":"10.1056\/NEJM199412013312203","volume":"331","author":"LP Aiello","year":"1994","unstructured":"Aiello LP, Avery RL, Arrigg PG, Keyt BA, Jampel HD, Shah ST et al (1994) Vascular endothelial growth factor in ocular fluid of patients with diabetic retinopathy and other retinal disorders. N Engl J Med 331(22):1480\u20131487","journal-title":"N Engl J Med"},{"key":"4282_CR69","doi-asserted-by":"publisher","DOI":"10.1155\/2017\/3691349","author":"N El-Najjar","year":"2017","unstructured":"El-Najjar N, Kulkarni RP, Nader N, Hodeify R, Machaca K (2017) Effects of hyperglycemia on vascular smooth muscle Ca(2+) signaling. BioMed Res Int. https:\/\/doi.org\/10.1155\/2017\/3691349","journal-title":"BioMed Res Int"},{"issue":"6","key":"4282_CR70","doi-asserted-by":"publisher","DOI":"10.1016\/j.xops.2024.100557","volume":"4","author":"R Haliyur","year":"2024","unstructured":"Haliyur R, Marwah S, Mittal S, Stein JD, Shah AR, Pershing S et al (2024) Demographic and metabolic risk factors associated with development of diabetic macular edema among persons with diabetes mellitus. Ophthalmology Science 4(6):100557","journal-title":"Ophthalmology Science"},{"issue":"6","key":"4282_CR71","doi-asserted-by":"publisher","DOI":"10.1016\/j.heliyon.2023.e16830","volume":"9","author":"M Zhang","year":"2023","unstructured":"Zhang M, Wu J, Wang Y, Wu J, Hu W, Jia H et al (2023) Associations between blood pressure levels and diabetic retinopathy in patients with diabetes mellitus: a population-based study. Heliyon 9(6):e16830","journal-title":"Heliyon"},{"issue":"1","key":"4282_CR72","doi-asserted-by":"publisher","DOI":"10.1186\/s12902-017-0170-x","volume":"17","author":"A Bastawrous","year":"2017","unstructured":"Bastawrous A, Mathenge W, Wing K, Bastawrous M, Rono H, Weiss HA et al (2017) The incidence of diabetes mellitus and diabetic retinopathy in a population-based cohort study of people aged 50\u00a0years and over in Nakuru, Kenya. BMC Endocr Disord 17(1):19","journal-title":"BMC Endocr Disord"},{"issue":"2","key":"4282_CR73","first-page":"105","volume":"51","author":"G Sharew","year":"2013","unstructured":"Sharew G, Ilako DR, Kimani K, Gelaw Y (2013) Prevalence of diabetic retinopathy in Jimma University Hospital. Southwest Ethiopia Ethiopian Medical Journal 51(2):105\u2013113","journal-title":"Southwest Ethiopia Ethiopian Medical Journal"},{"issue":"3","key":"4282_CR74","doi-asserted-by":"publisher","first-page":"813","DOI":"10.2337\/diabetes.55.03.06.db05-0937","volume":"55","author":"K Guan","year":"2006","unstructured":"Guan K, Hudson C, Wong T, Kisilevsky M, Nrusimhadevara RK, Lam WC et al (2006) Retinal hemodynamics in early diabetic macular edema. Diabetes 55(3):813\u2013818","journal-title":"Diabetes"},{"issue":"3","key":"4282_CR75","doi-asserted-by":"publisher","first-page":"497","DOI":"10.1016\/j.ophtha.2008.10.016","volume":"116","author":"R Klein","year":"2009","unstructured":"Klein R, Knudtson MD, Lee KE, Gangnon R, Klein BE (2009) The Wisconsin Epidemiologic Study of Diabetic Retinopathy XXIII: the twenty-five-year incidence of macular edema in persons with type 1 diabetes. Ophthalmology 116(3):497\u2013503","journal-title":"Ophthalmology"},{"issue":"9","key":"4282_CR76","doi-asserted-by":"publisher","first-page":"1820","DOI":"10.1016\/j.ophtha.2015.05.011","volume":"122","author":"R Das","year":"2015","unstructured":"Das R, Kerr R, Chakravarthy U, Hogg RE (2015) Dyslipidemia and diabetic macular edema: a systematic review and meta-analysis. Ophthalmology 122(9):1820\u20131827","journal-title":"Ophthalmology"},{"issue":"2","key":"4282_CR77","doi-asserted-by":"publisher","first-page":"173","DOI":"10.4103\/tjosr.tjosr_17_24","volume":"62","author":"U Ramalingam","year":"2024","unstructured":"Ramalingam U, Annamalai R, Basak R (2024) A comparative study of serum lipid profiles in diabetic patients with and without clinically significant macular oedema. tnoa Journal of Ophthalmic Science and Research 62(2):173\u2013179","journal-title":"tnoa Journal of Ophthalmic Science and Research"},{"issue":"1","key":"4282_CR78","doi-asserted-by":"publisher","DOI":"10.1007\/s10792-024-03263-x","volume":"44","author":"HM Hiran","year":"2024","unstructured":"Hiran HM, Kamath A, Mendonca TM, Rodrigues GR, Nayak RR, Kamath G et al (2024) Association of serum lipid profile and other systemic risk factors with retinal hard exudates in diabetic retinopathy. Int Ophthalmol 44(1):338","journal-title":"Int Ophthalmol"},{"issue":"9","key":"4282_CR79","doi-asserted-by":"publisher","first-page":"1079","DOI":"10.1001\/archopht.1996.01100140281004","volume":"114","author":"EY Chew","year":"1996","unstructured":"Chew EY, Klein ML, Ferris FL III, Remaley NA, Murphy RP, Chantry K et al (1996) Association of elevated serum lipid levels with retinal hard exudate in diabetic retinopathy: Early Treatment Diabetic Retinopathy Study (ETDRS) Report 22. Arch Ophthalmol 114(9):1079\u20131084","journal-title":"Arch Ophthalmol"},{"issue":"5","key":"4282_CR80","doi-asserted-by":"publisher","first-page":"503","DOI":"10.1001\/jamaophthalmol.2014.5108","volume":"133","author":"BEK Klein","year":"2015","unstructured":"Klein BEK, Myers CE, Howard KP, Klein R (2015) Serum lipids and proliferative diabetic retinopathy and macular edema in persons with long-term Type 1 Diabetes Mellitus: the wisconsin epidemiologic study of diabetic retinopathy. JAMA Ophthalmology 133(5):503\u2013510","journal-title":"JAMA Ophthalmology"},{"issue":"10","key":"4282_CR81","doi-asserted-by":"publisher","first-page":"7464","DOI":"10.1167\/iovs.11-7598","volume":"52","author":"R Benarous","year":"2011","unstructured":"Benarous R, Sasongko MB, Qureshi S, Fenwick E, Dirani M, Wong TY et al (2011) Differential association of serum lipids with diabetic retinopathy and diabetic macular edema. Invest Ophthalmol Vis Sci 52(10):7464\u20137469","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"4282_CR82","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1186\/s40662-015-0026-2","volume":"2","author":"R Lee","year":"2015","unstructured":"Lee R, Wong TY, Sabanayagam C (2015) Epidemiology of diabetic retinopathy, diabetic macular edema and related vision loss. Eye and Vision (London, England) 2:17","journal-title":"Eye and Vision (London, England)"},{"issue":"5","key":"4282_CR83","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2021-056332","volume":"12","author":"W Li","year":"2022","unstructured":"Li W, Gong X, Wang W, Xiong K, Meng J, Li Y et al (2022) Association of different kinds of obesity with diabetic retinopathy in patients with type 2 diabetes. BMJ Open 12(5):e056332","journal-title":"BMJ Open"},{"issue":"2","key":"4282_CR84","doi-asserted-by":"publisher","first-page":"170","DOI":"10.1034\/j.1600-0420.1999.770211.x","volume":"77","author":"JM Lopes de Faria","year":"1999","unstructured":"Lopes de Faria JM, Jalkh AE, Trempe CL, McMeel JW (1999) Diabetic macular edema: risk factors and concomitants. Acta Ophthalmol Scand 77(2):170\u2013175","journal-title":"Acta Ophthalmol Scand"},{"issue":"3","key":"4282_CR85","doi-asserted-by":"publisher","first-page":"592","DOI":"10.2337\/dc11-0943","volume":"35","author":"CD Jones","year":"2012","unstructured":"Jones CD, Greenwood RH, Misra A, Bachmann MO (2012) Incidence and progression of diabetic retinopathy during 17 years of a population-based screening program in England. Diabetes Care 35(3):592\u2013596","journal-title":"Diabetes Care"},{"key":"4282_CR86","doi-asserted-by":"publisher","first-page":"104","DOI":"10.4314\/ambr.v3i2.6","volume":"3","author":"I Machingura Ruredzo","year":"2017","unstructured":"Machingura Ruredzo I, Macheka B, Mukona M, Mateveke K, Okwanga P, Gomo E (2017) Prevalence and risk factors associated with retinopathy in diabetic patients at Parirenyatwa Hospital outpatients\u2019 clinic in Harare, Zimbabwe. Archives of Medical and Biomedical Research 3:104","journal-title":"Archives of Medical and Biomedical Research"},{"issue":"6","key":"4282_CR87","first-page":"948","volume":"10","author":"ES Elwali","year":"2017","unstructured":"Elwali ES, Almobarak AO, Hassan MA, Mahmooud AA, Awadalla H, Ahmed MH (2017) Frequency of diabetic retinopathy and associated risk factors in Khartoum, Sudan: population-based study. Int J Ophthalmol 10(6):948\u2013954","journal-title":"Int J Ophthalmol"},{"issue":"12","key":"4282_CR88","first-page":"1464","volume":"91","author":"R Klein","year":"1984","unstructured":"Klein R, Klein BEK, Moss SE, Davis MD, DeMets DL (1984) The Wisconsin Epidemiologic Study of Diabetic Retinopathy: IV. Diabetic Macular Edema Ophthalmology 91(12):1464\u20131474","journal-title":"Diabetic Macular Edema Ophthalmology"},{"key":"4282_CR89","doi-asserted-by":"publisher","DOI":"10.1155\/2015\/582060","author":"F Semeraro","year":"2015","unstructured":"Semeraro F, Cancarini A, dell\u2019Omo R, Rezzola S, Romano MR, Costagliola C (2015) Diabetic retinopathy: vascular and inflammatory disease. J Diabetes Res. https:\/\/doi.org\/10.1155\/2015\/582060","journal-title":"J Diabetes Res"},{"issue":"4","key":"4282_CR90","doi-asserted-by":"publisher","first-page":"195","DOI":"10.1038\/s41574-020-00451-4","volume":"17","author":"DA Antonetti","year":"2021","unstructured":"Antonetti DA, Silva PS, Stitt AW (2021) Current understanding of the molecular and cellular pathology of diabetic retinopathy. Nat Rev Endocrinol 17(4):195\u2013206","journal-title":"Nat Rev Endocrinol"},{"issue":"4","key":"4282_CR91","doi-asserted-by":"publisher","first-page":"294","DOI":"10.1089\/tmj.2010.0155","volume":"17","author":"I Jivraj","year":"2011","unstructured":"Jivraj I, Ng M, Rudnisky CJ, Dimla B, Tambe E, Nathoo N et al (2011) Prevalence and severity of diabetic retinopathy in Northwest Cameroon as identified by teleophthalmology. Telemed J E Health 17(4):294\u2013298","journal-title":"Telemed J E Health"},{"issue":"4","key":"4282_CR92","doi-asserted-by":"publisher","first-page":"399","DOI":"10.1111\/j.1464-5491.2012.03756.x","volume":"30","author":"PI Burgess","year":"2013","unstructured":"Burgess PI, MacCormick I, Harding S, Bastawrous A, Beare N, Garner P (2013) Epidemiology of diabetic retinopathy and maculopathy in Africa: a systematic review. Diabet Med 30(4):399\u2013412","journal-title":"Diabet Med"},{"issue":"4","key":"4282_CR93","doi-asserted-by":"publisher","first-page":"260","DOI":"10.1111\/ceo.12696","volume":"44","author":"DSW Ting","year":"2016","unstructured":"Ting DSW, Cheung GCM, Wong TY (2016) Diabetic retinopathy: global prevalence, major risk factors, screening practices and public health challenges: a review. Clin Exp Ophthalmol 44(4):260\u2013277","journal-title":"Clin Exp Ophthalmol"},{"issue":"3","key":"4282_CR94","doi-asserted-by":"publisher","first-page":"556","DOI":"10.2337\/dc11-1909","volume":"35","author":"JW Yau","year":"2012","unstructured":"Yau JW, Rogers SL, Kawasaki R, Lamoureux EL, Kowalski JW, Bek T et al (2012) Global prevalence and major risk factors of diabetic retinopathy. Diabetes Care 35(3):556\u2013564","journal-title":"Diabetes Care"},{"issue":"2","key":"4282_CR95","first-page":"70","volume":"68","author":"AY Sukha","year":"2009","unstructured":"Sukha AY, Rubin A (2009) Demographic, medical and visual aspects of diabetic retinopathy (DR) and diabetic macular edema (DME) in South African diabetic patients. Afr Vision Eye Health 68(2):70\u201381","journal-title":"Afr Vision Eye Health"}],"container-title":["International Ophthalmology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10792-026-04282-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10792-026-04282-6","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10792-026-04282-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T16:02:20Z","timestamp":1790265740000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10792-026-04282-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,24]]},"references-count":95,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["4282"],"URL":"https:\/\/doi.org\/10.1007\/s10792-026-04282-6","relation":{},"ISSN":["1573-2630"],"issn-type":[{"value":"1573-2630","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,24]]},"assertion":[{"value":"2 February 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 September 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 September 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"All the authors declare that they have no competing interests.","order":1,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study received formal approval from the Institutional Research Ethics Review Committee (IRERC) of the School of Medicine, Debre Markos University. The research was conducted in strict adherence to the principles of the Declaration of Helsinki, with ethical approval granted under reference number R\/S\/O\/M\/24\/02\/2025 in March 2025. A letter of support was also written for Debre Markos Referral Hospital (the study setting). Written informed consent was meticulously secured from each participant before their involvement in the study. Study participants had the right to refuse participation, ask questions, or withdraw at any time. Privacy and confidentiality were maintained. Respondents diagnosed with diabetic macular edema were referred to the ophthalmic clinic for further management.","order":2,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":3,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"404"}}