May 2007
Volume 48, Issue 13
Free
ARVO Annual Meeting Abstract  |   May 2007
Six-Year Incidence of Visual Loss in African-Americans With Type 1 Diabetes
Author Affiliations & Notes
  • M. S. Roy
    UMD New Jersey Medical School, Newark, New Jersey
    Institute of Ophthalmology and Visual Science,
  • J. Skurnick
    UMD New Jersey Medical School, Newark, New Jersey
    Department of Preventive Medicine & Community Health,
  • Footnotes
    Commercial Relationships M.S. Roy, None; J. Skurnick, None.
  • Footnotes
    Support NIH Grant EY 09860; Lew Wasserman Merit Award from Research to Prevent Blindness, Inc, NY
Investigative Ophthalmology & Visual Science May 2007, Vol.48, 5009. doi:
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      M. S. Roy, J. Skurnick; Six-Year Incidence of Visual Loss in African-Americans With Type 1 Diabetes. Invest. Ophthalmol. Vis. Sci. 2007;48(13):5009.

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Abstract

Purpose:: To report the 6-year incidence of visual loss and associated risk factors in African-Americans with type 1 insulin-dependent diabetes mellitus.

Methods:: African-Americans with type 1 diabetes (n=483) who participated in the New Jersey 725 study were re-examined as part of a 6-year follow-up. Best-corrected visual acuity (VA) was measured using the Early Treatment Diabetic Retinopathy Study (EDTRS) protocol. A structured clinical interview, seven stereoscopic fundus photographs for severity of diabetic retinopathy (DR), and blood pressure measurements were obtained. Biological evaluation included blood and urine assays. Any visual loss was defined as VA <20/40 in the better eye, blindness as VA <20/200 in the better eye, and doubling of the visual angle (DVA) as the loss of >15 letters either in the better eye or in either eye between first and second visits.

Results:: Over the 6-year period, 19 (4.3%) of the 440 at-risk patients developed visual loss in the better eye, three (0.6%) became blind, 47(9.8%) developed DVA in the better eye, and 65(13.5%) DVA in either eye. Baseline older age, high glycosylated hemoglobin, increasing DR severity, and proteinuria were characteristics significantly and independently associated with DVA in either eye at follow-up.

Conclusions:: Six-year incidence of DVA in either eye (13.5%) is high in African-Americans with type 1 diabetes. Baseline poor glycemic control, retinopathy severity, proteinuria, and older age are strong predictors of visual loss in this population.

Keywords: clinical (human) or epidemiologic studies: natural history • diabetes • visual acuity 
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