OBJECTIVE Studies comparing the incidence of blindness in persons with and without diabetes are scarce worldwide. In Germany, a decline in the incidence of blindness was found during the 1990s. The aim of this study was to analyze the recent time trend.

RESEARCH DESIGN AND METHODS Data were based on administrative files in southern Germany to assess recipients of blindness allowance newly registered between 1 January 2008 and 31 December 2012. We estimated age- and sex-standardized incidence of blindness in people with and people without diabetes and the corresponding relative risk. Poisson regression was used to examine age- and sex-adjusted time trends.

RESULTS We identified 1,897 new cases of blindness (23.7% of which were associated with diabetes). We observed a strong decrease in incidence in both the population with diabetes (2008, 17.3 per 100,000 person-years [95% CI 13.6–21.1], and 2012, 8.9 per 100,000 person-years [6.3–11.6]: 16% decrease [10–22] per year) and that without diabetes (2008, 9.3 per 100,000 person-years [8.3–10.3], and 2012, 6.6 [5.8–7.4]: 9% decrease [5–13] per year). The relative risk comparing those incidences was 1.70 (95% CI 1.32–2.16) and remained constant in the observation period. Regarding time trend, we found similar results for both sexes.

CONCLUSIONS We found a significant reduction in incidence of blindness in the populations with and without diabetes, which was more prominent among individuals with diabetes compared with the 1990s. Our findings may be explained by effective secondary prevention therapies and improved ophthalmologic care beyond diabetic retinopathy, particularly regarding macular degeneration, which means earlier detection and earlier and better treatment.

目的在糖尿病和非糖尿病人失明比较的发病率研究是稀缺全世界。在德国，1990年代失明的发生率有所下降。这项研究的目的是分析最近的时间趋势。

研究设计与方法数据基于德国南部的行政档案，以评估2008年1月1日至2012年12月31日期间新登记的失明津贴领取者。我们估计了患有糖尿病和非糖尿病的人的年龄和性别标准化失明发生率相应的相对风险。Poisson回归用于检验年龄和性别调整后的时间趋势。

结果我们确定了1,897例新失明病例（其中23.7％与糖尿病有关）。我们观察到糖尿病患者的发病率均大幅下降（2008年，每100,000人年17.3 [95％CI 13.6-21.1]，2012年，每100,000人年8.9 [6.3-11.6]：降低16％[每年[10–22]）和没有糖尿病的糖尿病（2008年，每100,000人年9.3 [8.3–10.3]，2012年，则是6.6 [5.8–7.4]：每年减少9％[5-13]）。比较这些发生率的相对风险是1.70（95％CI 1.32–2.16），并且在观察期内保持不变。关于时间趋势，我们发现两性相似的结果。

结论我们发现患有和不患有糖尿病的人群中失明的发生率显着降低，与1990年代相比，在患有糖尿病的人群中更为显着。我们的发现可以通过有效的二级预防疗法和改善的糖尿病眼病以外的眼科护理来解释，特别是在黄斑变性方面，这意味着更早发现和更早更好的治疗。