ORIGINAL RESEARCH article
Front. Clin. Diabetes Healthc.
Sec. Diabetes Clinical Epidemiology
Volume 6 - 2025 | doi: 10.3389/fcdhc.2025.1631252
This article is part of the Research TopicPrevention and Treatment Advancements in Diabetic RetinopathyView all 16 articles
COVID-19 Pandemic Impact on a Diabetic Retinopathy Screening Program in Andalusia: A Population-Based Study
Provisionally accepted
Reyes Ravé Garcia1
Pablo Rodríguez De Vera Gómez1
Eduardo Mayoral Sánchez2
MANUEL Aguilar Diosdado3,4María Asunción Martínez-Brocca1,2*- 1Department of Endocrinology and Nutrition. University Hospital Virgen Macarena, Seville, Spain
- 2Andalusian Comprehensive Healthcare Plan for Diabetes, Regional Ministry of Health, Seville, Spain
- 3Endocrinology and Nutrition, Puerta del Mar Hospital, Cadiz, Spain
- 4Biomedical Research and Innovation Institute of Cadiz (INiBICA), Cadiz, Spain
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Aims: To analyze the impact of the COVID-19 pandemic on the activity and outcomes of the Andalusian Program for Early Detection of Diabetic Retinopathy (APDR). Methods: A retrospective observational study was conducted during 2018–2023. The following variables were analyzed annually: newly included patients, retinal photographs performed, and pathological findings categorized by severity. Moderate-to-severe non-proliferative and proliferative retinopathy were classified as vision-threatening diabetic retinopathy (VTDR). Results: In 2020 and 2021, the number of newly included patients (11,897 and 18,343, respectively) and retinal photographs performed (39,667 and 64,092, respectively) decreased compared to previous years (2018 and 2019: 25,940 and 30,807 new patients, respectively; 85,171 and 100,849 retinal photographs, respectively). In 2022, activity levels increased 160% compared to 2019. The proportion of VTDR cases remained stable at 0.163%, 0.14%, and 0.075% during 2021, 2022, and 2023, respectively, compared to the prepandemic period (0.168% and 0.117% in 2018 and 2019, respectively). Conclusions: Despite the slowdown in activity during the COVID-19 pandemic, the post-pandemic proportion of VTDR cases diagnosed through the APDR remained stable, suggesting resilience against severe outcomes despite healthcare disruption. The program has demonstrated an effective recovery. Ongoing long-term monitoring is essential to fully assess the pandemic’s potential impact on late-stage complications.
Keywords: Diabetic Retinopathy, risk factor, Vision-threatening diabetic retinopathy, type 1 diabetes mellitus, COVID-19
Received: 19 May 2025; Accepted: 23 Jul 2025.
Copyright: © 2025 Ravé Garcia, Rodríguez De Vera Gómez, Mayoral Sánchez, Diosdado and Martínez-Brocca. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: María Asunción Martínez-Brocca, Department of Endocrinology and Nutrition. University Hospital Virgen Macarena, Seville, Spain
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