{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T20:08:57Z","timestamp":1772222937600,"version":"3.50.1"},"reference-count":24,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T00:00:00Z","timestamp":1756425600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Endowment Fund","award":["PRJ-73\/LPDP\/2019"],"award-info":[{"award-number":["PRJ-73\/LPDP\/2019"]}]},{"name":"World Class Research grant from the Ministry of Research and Higher Education, Government of Indonesia"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"\n Objectives<\/jats:title>\n To report the incidence and progression rate of diabetic retinopathy (DR) and blindness in Indonesian adults with type 2 diabetes.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n This was a prospective cohort study of 899 adults aged >30 years with confirmed type 2 diabetes. All participants underwent standardized clinical and eye examinations. Two-field retinal photographs were taken. DR was graded by trained grader masked to participants\u2019 clinical details. We categorized DR as follows: mild, moderate, severe non-proliferative (NPDR), and proliferative DR (PDR). Additional category of vision-threatening DR (VTDR) included severe NPDR or more, or moderate NPDR with clinically significant macular edema. Blindness was defined as visual acuity \u22643\/60. At least 1-step progression was categorized as DR progressing. Cox-proportional hazard model was used.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n The incidence and progression of DR were 34.6 and 35.1, and incidence of VTDR and blindness were 24.5 and 8.33\/1000 person-years, respectively. Longer diabetes duration was associated with increasing the risk of developing DR (Hazard ratio 1.37 [95% confidence interval 1.10\u20131.72]) and VTDR (2.00 [1.60\u20132.50]) and progressing DR (1.50 [1.23\u20131.84]) in 5 years. Obesity was associated with increased risk of developing DR (1.75 [1.14\u20132.68]) and the presence of gangrene (2.54 [1.49\u20134.35]) and neuropathy (1.50 [1.07\u20132.10]) at baseline increased the risk of progressing DR in 5 years. Living in rural area was associated with increased risk of blindness (2.50 [1.03\u20135.88]).<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n We reported the incidence and progression rate of DR, VTDR, and blindness, and documented that longer diabetes duration increased the risk of DR and VTDR in 5 years.<\/jats:p>\n <\/jats:sec>","DOI":"10.1371\/journal.pone.0322093","type":"journal-article","created":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T17:36:45Z","timestamp":1756489005000},"page":"e0322093","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Incidence and progression of diabetic retinopathy and blindness in Indonesian adults with type 2 diabetes"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0366-8335","authenticated-orcid":true,"given":"Muhammad Bayu","family":"Sasongko","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gandhi Anandika","family":"Febryanto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Supanji","family":"Haryanto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Firman Setya","family":"Wardhana","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yeni Dwi","family":"Lestari","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anggraeni","family":"Puspita","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0247-5387","authenticated-orcid":true,"given":"Felicia","family":"Widyaputri","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2025,8,29]]},"reference":[{"issue":"9735","key":"pone.0322093.ref001","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1016\/S0140-6736(09)62124-3","article-title":"Diabetic retinopathy","volume":"376","author":"N Cheung","year":"2010","journal-title":"Lancet"},{"issue":"3","key":"pone.0322093.ref002","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":"JWY Yau","year":"2012","journal-title":"Diabetes Care"},{"key":"pone.0322093.ref003","doi-asserted-by":"crossref","DOI":"10.2337\/db18-202-LB","article-title":"Global prevalence of type 2 diabetes over the next ten years (2018-2028)","volume":"67","author":"AB Kaiser","year":"2018","journal-title":"Diabetes"},{"key":"pone.0322093.ref004","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1016\/j.diabres.2017.03.024","article-title":"IDF Diabetes Atlas: Global estimates for the prevalence of diabetes for 2015 and 2040","volume":"128","author":"K Ogurtsova","year":"2017","journal-title":"Diabetes Res Clin Pract"},{"issue":"5","key":"pone.0322093.ref005","doi-asserted-by":"crossref","first-page":"1047","DOI":"10.2337\/diacare.27.5.1047","article-title":"Global prevalence of diabetes","volume":"27","author":"S Wild","year":"2004","journal-title":"Diabetes Care"},{"key":"pone.0322093.ref006","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1016\/j.ajo.2017.06.019","article-title":"Prevalence of diabetic retinopathy and blindness in indonesian adults with type 2 diabetes","volume":"181","author":"MB Sasongko","year":"2017","journal-title":"Am J Ophthalmol"},{"issue":"2","key":"pone.0322093.ref007","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1016\/S2213-8587(18)30128-1","article-title":"Incidence and progression of diabetic retinopathy: a systematic review","volume":"7","author":"C Sabanayagam","year":"2019","journal-title":"Lancet Diabetes Endocrinol"},{"issue":"1","key":"pone.0322093.ref008","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1080\/09286586.2016.1255763","article-title":"Rationale and Methodology for a Community-Based Study of Diabetic Retinopathy in an Indonesian Population with Type 2 Diabetes Mellitus: The Jogjakarta Eye Diabetic Study in the Community","volume":"24","author":"MB Sasongko","year":"2017","journal-title":"Ophthalmic Epidemiol"},{"issue":"11","key":"pone.0322093.ref009","doi-asserted-by":"crossref","first-page":"2377","DOI":"10.2337\/dc18-1074","article-title":"Estimated resting metabolic rate and body composition measures are strongly associated with diabetic retinopathy in Indonesian adults with type 2 diabetes","volume":"41","author":"MB Sasongko","year":"2018","journal-title":"Diabetes Care"},{"key":"pone.0322093.ref010","doi-asserted-by":"crossref","first-page":"741","DOI":"10.1016\/S0161-6420(13)38009-9","article-title":"Early Treatment Diabetic Retinopathy Study design and baseline patient characteristics. 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