{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T01:45:21Z","timestamp":1775699121310,"version":"3.50.1"},"reference-count":50,"publisher":"Elsevier BV","issue":"2","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2025,8,7]],"date-time":"2025-08-07T00:00:00Z","timestamp":1754524800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["canadianjournalofophthalmology.ca","clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Canadian Journal of Ophthalmology"],"published-print":{"date-parts":[[2026,4]]},"DOI":"10.1016\/j.jcjo.2025.08.001","type":"journal-article","created":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T11:14:08Z","timestamp":1757070848000},"page":"381-392","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"title":["The prevalence of diabetic retinopathy in Indigenous and non-Indigenous populations in Canada: systematic review and meta-analysis"],"prefix":"10.1016","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7176-6631","authenticated-orcid":false,"given":"Keean","family":"Nanji","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michele","family":"Zaman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0652-6946","authenticated-orcid":false,"given":"Felicia","family":"Tai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caberry W.","family":"Yu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-0831-1915","authenticated-orcid":false,"given":"David","family":"Mikhail","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6066-9548","authenticated-orcid":false,"given":"Jane","family":"Jomy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark","family":"Phillips","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dena","family":"Zeraatkar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yih Chung","family":"Tham","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8448-1264","authenticated-orcid":false,"given":"Tien Yin","family":"Wong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sobha","family":"Sivaprasad","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7756-5091","authenticated-orcid":false,"given":"Charles C.","family":"Wykoff","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9988-4146","authenticated-orcid":false,"given":"Varun","family":"Chaudhary","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"78","reference":[{"key":"10.1016\/j.jcjo.2025.08.001_bib0001","first-page":"306","article-title":"At-a-glance - Twenty years of diabetes surveillance using the Canadian Chronic Disease Surveillance System","volume":"39","author":"LeBlanc","year":"2019","journal-title":"Heal Promot Chronic Dis Prev Canada Res Policy Pract"},{"key":"10.1016\/j.jcjo.2025.08.001_bib0002","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1038\/sj.eye.6701879","article-title":"The prevalence of low vision and blindness in Canada","volume":"20","author":"Maberley","year":"2006","journal-title":"Eye (Lond)"},{"key":"10.1016\/j.jcjo.2025.08.001_bib0003","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1016\/j.diabres.2016.11.022","article-title":"Call to action: A new path for improving diabetes care for Indigenous peoples, a global review","volume":"123","author":"Harris","year":"2017","journal-title":"Diabetes Res Clin Pract"},{"key":"10.1016\/j.jcjo.2025.08.001_bib0004","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1016\/j.jcjo.2011.06.006","article-title":"The cost of vision loss in Canada. 2. Results","volume":"46","author":"Cruess","year":"2011","journal-title":"Can J Ophthalmol"},{"key":"10.1016\/j.jcjo.2025.08.001_bib0005","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1503\/cmaj.090846","article-title":"Epidemiology of diabetes mellitus among First Nations and non-First Nations adults","volume":"182","author":"Dyck","year":"2010","journal-title":"C Can Med Assoc J"},{"key":"10.1016\/j.jcjo.2025.08.001_bib0006","unstructured":"Public Health Agency of Canada. Report from the National Diabetes Surveillance System: Diabetes in Canada, 2009. 2009; 28 pages. http:\/\/www.ndss.gc.ca"},{"key":"10.1016\/j.jcjo.2025.08.001_bib0007","doi-asserted-by":"crossref","first-page":"53","DOI":"10.24095\/hpcdp.33.1.07","article-title":"Report summary diabetes in Canada: facts and figures from a public health perspective","volume":"33","author":"Pelletier","year":"2012","journal-title":"Chronic Dis Inj Can"},{"key":"10.1016\/j.jcjo.2025.08.001_bib0008","first-page":"386","article-title":"Diabetes care and health status of First Nations individuals with type 2 diabetes in Alberta","volume":"55","author":"Oster","year":"2009","journal-title":"Can Fam Physician"},{"key":"10.1016\/j.jcjo.2025.08.001_bib0009","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1016\/j.ophtha.2022.07.024","article-title":"Prevalence of diabetic retinopathy in Indigenous and non-Indigenous Australians: a systematic review and meta-analysis","volume":"130","author":"Chia","year":"2023","journal-title":"Ophthalmology"},{"key":"10.1016\/j.jcjo.2025.08.001_bib0010","first-page":"302","article-title":"Prevalence of diabetic retinopathy, proliferative diabetic retinopathy and non-proliferative diabetic retinopathy in Asian T2DM patients: a systematic review and Meta-analysis","volume":"12","author":"Yang","year":"2019","journal-title":"Int J Ophthalmol"},{"key":"10.1016\/j.jcjo.2025.08.001_bib0011","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1016\/j.survophthal.2012.01.004","article-title":"Prevalence of diabetic retinopathy in various ethnic groups: a worldwide perspective","volume":"57","author":"Sivaprasad","year":"2012","journal-title":"Surv Ophthalmol"},{"key":"10.1016\/j.jcjo.2025.08.001_bib0012","article-title":"The PRISMA 2020 statement: an updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"10.1016\/j.jcjo.2025.08.001_bib0013","doi-asserted-by":"crossref","first-page":"974","DOI":"10.1136\/jech-2013-203104","article-title":"Meta-analysis of prevalence","volume":"67","author":"Barendregt","year":"2013","journal-title":"J Epidemiol Community Health"},{"key":"10.1016\/j.jcjo.2025.08.001_bib0014","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1097\/XEB.0000000000000054","article-title":"Methodological guidance for systematic reviews of observational epidemiological studies reporting prevalence and cumulative incidence data","volume":"13","author":"Munn","year":"2015","journal-title":"Int J Evid Based Healthc"},{"key":"10.1016\/j.jcjo.2025.08.001_bib0015","unstructured":"Higgins J, Thomas J, Chandler J, Cumpston M, Li T, Welch V. Cochrane Handbook for Systematic Reviews of Interventions | Cochrane Training. 2021. www.cochrane.org\/handbook."},{"key":"10.1016\/j.jcjo.2025.08.001_bib0016","doi-asserted-by":"crossref","first-page":"E901","DOI":"10.1503\/cmaj.200077","article-title":"Development of the instrument to assess the credibility of effect modification analyses (ICEMAN) in randomized controlled trials and meta-analyses","volume":"192","author":"Schandelmaier","year":"2020","journal-title":"CMAJ"},{"key":"10.1016\/j.jcjo.2025.08.001_bib0017","unstructured":"Package \u201cmeta\u201d: General Package for Meta-Analysis. Version 8.2-0. July 23, 2023. https:\/\/github.com\/guido-s\/meta\/"},{"key":"10.1016\/j.jcjo.2025.08.001_bib0018","doi-asserted-by":"crossref","first-page":"280","DOI":"10.7326\/0003-4819-158-4-201302190-00009","article-title":"Assessing bias in studies of prognostic factors","volume":"158","author":"Hayden","year":"2013","journal-title":"Ann Intern Med"},{"key":"10.1016\/j.jcjo.2025.08.001_bib0019","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1016\/j.jclinepi.2019.12.023","article-title":"GRADE Guidelines 28: use of GRADE for the assessment of evidence about prognostic factors: rating certainty in identification of groups of patients with different absolute risks","volume":"121","author":"Foroutan","year":"2020","journal-title":"J Clin Epidemiol"},{"key":"10.1016\/j.jcjo.2025.08.001_bib0020","doi-asserted-by":"crossref","first-page":"h870","DOI":"10.1136\/bmj.h870","article-title":"Use of GRADE for assessment of evidence about prognosis: rating confidence in estimates of event rates in broad categories of patients","volume":"350","author":"Iorio","year":"2015","journal-title":"BMJ"},{"key":"10.1016\/j.jcjo.2025.08.001_bib0021","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1016\/j.jclinepi.2019.10.014","article-title":"GRADE guidelines 26: informative statements to communicate the findings of systematic reviews of interventions","volume":"119","author":"Santesso","year":"2020","journal-title":"J Clin Epidemiol"},{"key":"10.1016\/j.jcjo.2025.08.001_bib0022","unstructured":"Framework for diabetes in Canada - Canada. Accessed November 3, 2023.https:\/\/www.canada.ca\/en\/public-health\/services\/publications\/diseases-conditions\/framework-diabetes-canada.html#a7"},{"key":"10.1016\/j.jcjo.2025.08.001_bib0023","unstructured":"Indigenous communities and diabetes - Diabetes Canada. Accessed November 3, 2023. https:\/\/www.diabetes.ca\/resources\/tools\u2014resources\/indigenous-communities-and-diabetes"},{"key":"10.1016\/j.jcjo.2025.08.001_bib0024","doi-asserted-by":"crossref","DOI":"10.1016\/j.diabres.2022.110022","article-title":"The association of attained age, age at diagnosis, and duration of type 2 diabetes with the long-term risk for major diabetes-related complications","volume":"190","author":"Morton","year":"2022","journal-title":"Diabetes Res Clin Pract"},{"key":"10.1016\/j.jcjo.2025.08.001_bib0025","first-page":"E282","article-title":"Diabetes-induced eye disease among First Nations people in Ontario: a longitudinal, population-based cohort study","volume":"8","author":"Campbell","year":"2020","journal-title":"Can Med Assoc Open Access J"},{"key":"10.1016\/j.jcjo.2025.08.001_bib0026","doi-asserted-by":"crossref","first-page":"1334","DOI":"10.1001\/jamaophthalmol.2014.2854","article-title":"Prevalence of and risk factors for diabetic macular edema in the United States","volume":"132","author":"Varma","year":"2014","journal-title":"JAMA Ophthalmol"},{"key":"10.1016\/j.jcjo.2025.08.001_bib0027","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1016\/j.ophtha.2017.10.026","article-title":"Ethnic differences in the prevalence and risk factors of diabetic retinopathy: The Singapore Epidemiology of Eye Diseases Study","volume":"125","author":"Tan","year":"2018","journal-title":"Ophthalmology"},{"key":"10.1016\/j.jcjo.2025.08.001_bib0028","doi-asserted-by":"crossref","first-page":"410","DOI":"10.2337\/dc08-1422","article-title":"Higher prevalence of retinopathy in diabetic patients of South Asian ethnicity compared with White Europeans in the community: a cross-sectional study","volume":"32","author":"Raymond","year":"2009","journal-title":"Diabetes Care"},{"key":"10.1016\/j.jcjo.2025.08.001_bib0029","doi-asserted-by":"crossref","first-page":"1580","DOI":"10.1016\/j.ophtha.2021.04.027","article-title":"Global prevalence of diabetic retinopathy and projection of burden through 2045: Systematic review and meta-analysis","volume":"128","author":"Teo","year":"2021","journal-title":"Ophthalmology"},{"key":"10.1016\/j.jcjo.2025.08.001_bib0030","doi-asserted-by":"crossref","first-page":"556","DOI":"10.2337\/dc11-1909","article-title":"Global prevalence and major risk factors of diabetic retinopathy","volume":"35","author":"Yau","year":"2012","journal-title":"Diabetes Care"},{"key":"10.1016\/j.jcjo.2025.08.001_bib0031","doi-asserted-by":"crossref","first-page":"1580","DOI":"10.1016\/j.ophtha.2021.04.027","article-title":"Global prevalence of diabetic retinopathy and projection of burden through 2045: systematic review and meta-analysis","volume":"128","author":"Teo","year":"2021","journal-title":"Ophthalmology"},{"key":"10.1016\/j.jcjo.2025.08.001_bib0032","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2017-016280","article-title":"Risk factors of diabetic retinopathy and sight-threatening diabetic retinopathy: a cross-sectional study of 13 473 patients with type 2 diabetes mellitus in mainland China","volume":"7","author":"Liu","year":"2017","journal-title":"BMJ Open"},{"key":"10.1016\/j.jcjo.2025.08.001_bib0033","unstructured":"Sight loss prevention and diabetes - Diabetes Canada Accessed November 15, 2023. https:\/\/www.diabetes.ca\/advocacy\u2014policies\/our-policy-positions\/sight-loss-prevention-and-diabetes#"},{"key":"10.1016\/j.jcjo.2025.08.001_bib0034","doi-asserted-by":"crossref","first-page":"S19","DOI":"10.1016\/j.jcjo.2017.09.023","article-title":"Risk factors for progression of diabetic retinopathy in Alberta First Nations communities","volume":"52","author":"Rudnisky","year":"2017","journal-title":"Can J Ophthalmol"},{"key":"10.1016\/j.jcjo.2025.08.001_bib0035","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1016\/S0008-4182(03)80111-4","article-title":"Use of telemedicine in screening for diabetic retinopathy","volume":"38","author":"Choremis","year":"2003","journal-title":"Can J Ophthalmol"},{"key":"10.1016\/j.jcjo.2025.08.001_bib0036","first-page":"286","article-title":"Factors associated with increased prevalence of diabetic retinopathy: a clinical survey","volume":"97","author":"Szabo","year":"1967","journal-title":"Can Med Assoc J"},{"key":"10.1016\/j.jcjo.2025.08.001_bib0037","doi-asserted-by":"crossref","first-page":"583","DOI":"10.1089\/15209150050502005","article-title":"Tele-ophthalmology via stereoscopic digital imaging: a pilot project","volume":"2","author":"Tennant","year":"2000","journal-title":"Diabetes Technol Ther"},{"key":"10.1016\/j.jcjo.2025.08.001_bib0038","doi-asserted-by":"crossref","first-page":"28","DOI":"10.3129\/i09-220","article-title":"The prevalence of diabetic retinopathy as identified by teleophthalmology in rural Alberta","volume":"45","author":"Nathoo","year":"2010","journal-title":"Can J Ophthalmol"},{"key":"10.1016\/j.jcjo.2025.08.001_bib0039","doi-asserted-by":"crossref","first-page":"S15","DOI":"10.1016\/j.jcjo.2017.09.022","article-title":"Six-year prevalence and incidence of diabetic retinopathy and cost-effectiveness of tele-ophthalmology in Manitoba","volume":"52","author":"Kanjee","year":"2017","journal-title":"Can J Ophthalmol"},{"key":"10.1016\/j.jcjo.2025.08.001_bib0040","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1016\/j.jcjo.2018.07.004","article-title":"Toronto tele-retinal screening program for detection of diabetic retinopathy and macular edema","volume":"54","author":"Felfeli","year":"2019","journal-title":"Can J Ophthalmol"},{"key":"10.1016\/j.jcjo.2025.08.001_bib0041","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1016\/j.jcjd.2021.05.001","article-title":"Sociodemographics Associated With Risk of Diabetic Retinopathy Detected by Tele-Ophthalmology: 5-Year Results of the Toronto Tele-Retinal Screening Program","volume":"46","author":"Cao","year":"2022","journal-title":"Can J Diabetes"},{"key":"10.1016\/j.jcjo.2025.08.001_bib0042","doi-asserted-by":"crossref","first-page":"658","DOI":"10.3129\/i08-120","article-title":"Teleophthalmology screening for diabetic retinopathy through mobile imaging units within Canada","volume":"43","author":"Boucher","year":"2008","journal-title":"Can J Ophthalmol"},{"key":"10.1016\/j.jcjo.2025.08.001_bib0043","article-title":"Prevalence of Diabetes and Diabetes-related Complications in First Nations Communities in Northern Quebec (Eeyou Istchee)","author":"Dannenbaum","year":"2008","journal-title":"Canada"},{"key":"10.1016\/j.jcjo.2025.08.001_bib0044","unstructured":"Oster RT, Virani S, Strong D, Frcpc MD, Shade S, Toth EL. Research Diabetes care and health status of First Nations individuals with type 2 diabetes in Alberta n.d."},{"key":"10.1016\/j.jcjo.2025.08.001_bib0045","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1076\/opep.9.3.153.1515","article-title":"Risk factors for diabetic retinopathy in the Cree of James Bay","volume":"9","author":"Maberley","year":"2002","journal-title":"Ophthalmic Epidemiol"},{"key":"10.1016\/j.jcjo.2025.08.001_bib0046","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1076\/opep.9.3.169.1517","article-title":"Digital photographic screening for diabetic retinopathy in the James Bay Cree","volume":"9","author":"Maberley","year":"2002","journal-title":"Ophthalmic Epidemiol"},{"key":"10.1016\/j.jcjo.2025.08.001_bib0047","doi-asserted-by":"crossref","unstructured":"Hanley AJG, Harris SB, Mamakeesick M, Goodwin K, Fiddler E, Hegele RA, et al. Complications of Type 2 Diabetes Among Aboriginal Canadians Prevalence and associated risk factors 2005.","DOI":"10.2337\/diacare.28.8.2054"},{"key":"10.1016\/j.jcjo.2025.08.001_bib0048","doi-asserted-by":"crossref","first-page":"S19","DOI":"10.1016\/j.jcjo.2017.09.023","article-title":"Risk factors for progression of diabetic retinopathy in Alberta First Nations communities","volume":"52","author":"Rudnisky","year":"2017","journal-title":"Can J Ophthalmol Can d\u2019ophtalmologie"},{"key":"10.1016\/j.jcjo.2025.08.001_bib0049","doi-asserted-by":"crossref","DOI":"10.1080\/22423982.2017.1422670","article-title":"Nurse-led diabetic retinopathy screening: a pilot study to evaluate a new approach to vision care for Canadian Aboriginal peoples","volume":"77","author":"Spurr","year":"2018","journal-title":"Int J Circumpolar Health"},{"key":"10.1016\/j.jcjo.2025.08.001_bib0050","article-title":"Diabetic Retinopathy in Native and Nonnative Canadians","volume":"2007","author":"Ross","year":"2007","journal-title":"Exp Diabetes Res"}],"container-title":["Canadian Journal of Ophthalmology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0008418225003618?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0008418225003618?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T00:48:31Z","timestamp":1775695711000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0008418225003618"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4]]},"references-count":50,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,4]]}},"alternative-id":["S0008418225003618"],"URL":"https:\/\/doi.org\/10.1016\/j.jcjo.2025.08.001","relation":{},"ISSN":["0008-4182"],"issn-type":[{"value":"0008-4182","type":"print"}],"subject":[],"published":{"date-parts":[[2026,4]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"The prevalence of diabetic retinopathy in Indigenous and non-Indigenous populations in Canada: systematic review and meta-analysis","name":"articletitle","label":"Article Title"},{"value":"Canadian Journal of Ophthalmology","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.jcjo.2025.08.001","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2025 The Author(s). Published by Elsevier Inc. on behalf of Canadian Ophthalmological Society.","name":"copyright","label":"Copyright"}]}}