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J.R. Chao, M.Y. Lai, R. Klein, R. Varma, Los Angeles Latino Eye Study Group; Retinopathy in Persons Without Diabetes: The Los Angeles Latino Eye Study . Invest. Ophthalmol. Vis. Sci. 2006;47(13):1553.
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To assess the prevalence and relationship of non–diabetic retinopathy (NDR) to various clinical characteristics in a population–based cohort of adult Latinos.
Six thousand three hundred fifty–seven Latinos aged 40 years and older in Los Angeles County, California participating in LALES underwent a complete ophthalmic examination, history taking, blood pressure measurement, waist/hip circumference measurement, and laboratory testing. Persons without diabetes were defined as those with glycosylated hemoglobin of < 7.0 % and random blood glucose of < 200 mg/dl. Stereoscopic color fundus photographs were graded to determine presence of retinopathy (defined as retinal microaneurysms only, blot hemorrhages only, hemorrhages and/or microaneurysms, cotton wool spots, hard exudates, intraretinal microvascular abnormalities, venous beading, and retinal new vessels). Participants with retinal vein occlusions were excluded from the analyses.
4718 participants without diabetes were included in this analysis. Retinopathy was present in 319 subjects (6.7%) in the non–diabetic population and varied from 5.7% in persons 40–49 years of age to 12.9% in persons 80–89 years of age. Univariate analysis revealed that age, gender, systolic and diastolic blood pressure, ocular perfusion pressure, body mass index, and waist/hip ratio were significantly associated with NDR. When adjusted for age and gender, the other variables remained significant. Stepwise multivariate logistic regression analysis indicated that male gender and systolic blood pressure were associated with retinopathy in participants without diabetes (odds ratio [OR] = 1.5, 95% CI: 1.19–1.89; and 2.3, 95% CI: 1.5–3.1, respectively). The prevalence of moderate/severe visual impairment (best corrected worse than or equal to 20/80) was 0.3% among persons without retinopathy and 1.5% among persons with NDR. Glycosylated hemoglobin levels of < 7.0% and random blood glucose levels of < 200 mg/dl were not associated with retinopathy.
Our data suggest that independent risk indicators for NDR are male gender and elevated systolic blood pressure. While there is a higher prevalence of visual impairment in the persons with NDR, further study is required to determine if NDR plays a causal role in this visual impairment.
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