{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T20:00:12Z","timestamp":1787860812580,"version":"build-2784847793"},"reference-count":17,"publisher":"MDPI AG","issue":"20","license":[{"start":{"date-parts":[[2024,10,21]],"date-time":"2024-10-21T00:00:00Z","timestamp":1729468800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Medical University of Varna Science Fund","award":["19020"],"award-info":[{"award-number":["19020"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background: Diabetic retinopathy (DR) is a leading cause of visual impairment globally among working-aged individuals. This study aims to update data on DR prevalence in Bulgaria. Methods: The present cross-sectional study was conducted between 1 January 2022 and 1 January 2023, using a local diabetes registry from the city of Varna as a sampling framework. In total, 587 diabetic patients underwent DR examination. Data included demographics, diabetes type\/duration, treatment, and ophthalmic history. DR status was assessed using indirect slit-lamp biomicroscopy or digital fundus photography, graded by the International Clinical Diabetic Retinopathy Scale. Results: Of 587 participants, 13 were excluded due to cataract-related ungradable images. The median age was 65 years (IQR 56\u201373), with a slight female predominance (54%). The overall prevalence of any DR was 39.9% (95% CI 35.9\u201344.0), with non-proliferative DR (NPDR) at 27.5%, proliferative DR (PDR) at 7.3%, and macular edema (DME) at 5%. Type 1 diabetes patients had significantly higher DR prevalence (68.8%) than type 2 (34.1%, p &lt; 0.001). Men exhibited higher DR prevalence. Age and diabetes duration correlated positively with DR prevalence. Insulin treatment was associated with higher DR prevalence (55.6%) than oral antidiabetic treatment (22.5%, p &lt; 0.001) for type 2 diabetes patients. Among those diagnosed with DR, 70.9% received treatment, mainly laser therapy. Conclusions: These findings provide epidemiological insights for future research and emphasize the need for a comprehensive national DR screening program in Bulgaria. Technological advancements enable proactive measures to mitigate DR-related visual impairment and blindness, including widespread screening, even in rural areas.<\/jats:p>","DOI":"10.3390\/diagnostics14202340","type":"journal-article","created":{"date-parts":[[2024,10,21]],"date-time":"2024-10-21T08:53:11Z","timestamp":1729500791000},"page":"2340","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Prevalence of Diabetic Retinopathy Among Diabetic Patients from Northeastern Bulgaria"],"prefix":"10.3390","volume":"14","author":[{"given":"Zornitsa","family":"Zlatarova","sequence":"first","affiliation":[{"name":"Department of Optometry and Occupational Diseases, Medical University of Varna, 9002 Varna, Bulgaria"},{"name":"University Specialized Eye Hospital, 9002 Varna, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elitsa","family":"Hristova","sequence":"additional","affiliation":[{"name":"Department of Optometry and Occupational Diseases, Medical University of Varna, 9002 Varna, Bulgaria"},{"name":"University Specialized Eye Hospital, 9002 Varna, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3630-5936","authenticated-orcid":false,"given":"Kristina","family":"Bliznakova","sequence":"additional","affiliation":[{"name":"Department of Medical Equipment, Electronic and Information Technologies in Healthcare, Medical University of Varna, 9002 Varna, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Virginia","family":"Atanasova","sequence":"additional","affiliation":[{"name":"Department of Social Medicine and Healthcare Organization, Medical University of Varna, 9002 Varna, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhaneta","family":"Yaneva","sequence":"additional","affiliation":[{"name":"Second Department of Internal Diseases, Sector Endocrinology and Metabolic Diseases, Medical University of Varna, 9002 Varna, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darina","family":"Koseva","sequence":"additional","affiliation":[{"name":"Department of Optometry and Occupational Diseases, Medical University of Varna, 9002 Varna, Bulgaria"},{"name":"University Specialized Eye Hospital, 9002 Varna, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3834-8948","authenticated-orcid":false,"given":"Lidiya","family":"Zaduryan","sequence":"additional","affiliation":[{"name":"Department of Optometry and Occupational Diseases, Medical University of Varna, 9002 Varna, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4334-2169","authenticated-orcid":false,"given":"Gabriela","family":"Vasileva","sequence":"additional","affiliation":[{"name":"Department of Optometry and Occupational Diseases, Medical University of Varna, 9002 Varna, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daliya","family":"Stefanova","sequence":"additional","affiliation":[{"name":"University Specialized Eye Hospital, 9002 Varna, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0164-4903","authenticated-orcid":false,"given":"Klara","family":"Dokova","sequence":"additional","affiliation":[{"name":"Department of Social Medicine and Healthcare Organization, Medical University of Varna, 9002 Varna, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,10,21]]},"reference":[{"key":"ref_1","unstructured":"Magliano, D.J., Boyko, E.J., and IDF Diabetes Atlas 10th Edition Scientific Committee (2021). 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Stud."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1055\/a-2002-5116","article-title":"Screening Results for Diabetic Retinopathy in Germany in a Real-world Cohort in a Metropolitan Diabetes Care Center","volume":"131","author":"Mertes","year":"2023","journal-title":"Exp. Clin. Endocrinol. Diabetes"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"S63","DOI":"10.4103\/ijo.IJO_1917_19","article-title":"Guidelines for the prevention and management of diabetic retinopathy and diabetic eye disease in India: A synopsis","volume":"68","author":"Gilbert","year":"2020","journal-title":"Indian J. Ophthalmol."}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/14\/20\/2340\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T16:17:34Z","timestamp":1760113054000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/14\/20\/2340"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10,21]]},"references-count":17,"journal-issue":{"issue":"20","published-online":{"date-parts":[[2024,10]]}},"alternative-id":["diagnostics14202340"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics14202340","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,10,21]]}}}