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Vincent LaBarbera, Jeffrey Tran, Praneetha Thulasi, Andrew Hendrick; Prevalence and severity of diabetic retinopathy of predominantly African American population in urban environment. Invest. Ophthalmol. Vis. Sci. 2016;57(12):1600.
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© 2017 Association for Research in Vision and Ophthalmology.
Previous reports demonstrate African Americans have a higher prevalence of diabetic retinopathy (DR) and a higher risk of complications including blindness than Caucasian populations. This study assesses the prevalence and severity of DR and diabetic macular edema (DME) among a predominantly African-American population, using fundus photography obtained during routine endocrinology visits in a safety net setting.
This is a retrospective cross-sectional chart review of all adult patients who presented to the diabetes clinic at the Grady Memory Hospital in Atlanta, GA from August 15, 2012 to August 15, 2014 and also received ocular fundus photography. Subjects were identified by searching for Current Procedural Terminology (CPT) code 92250 (fundus photography with interpretation) generated through the endocrinology clinic. Fundus photography was evaluated by an ophthalmologist for image quality (1=ungradable, 2=poor, 3=acceptable, 4=good, 5=excellent), presence and severity of DR and macular edema by modified ETDRS criteria (mild, moderate, severe, proliferative +/- high risk characteristics) by convention. Demographic data were extracted from the medical record.
A total of 559 subjects were identified. 470 (84%) were African American, 270 (48%) male, and 495 (89%) had type 2 diabetes mellitus. The average HbA1C was 8.2%. Of these, 439 subjects (797 eyes) had fundus photos available for review by an ophthalmologist (PT). Image quality results are summarized in Fig. 1.The overall prevalence of DR was 35% and macular edema was 9.7%. Visual acuity was worse than 20/200 in 5% of subjects. DR severity results are summarized in Fig. 2.
The prevalence of DR seen in this predominantly African-American population (35%) is higher than the national average (28.5%) and similar to comparative studies of predominantly Hispanic populations (44%). This may represent more advanced disease due to worse disease control, increased disease duration, worse surveillance, or comorbidities such as systemic hypertension. Racial differences in DR prevalence and severity are multifactorial and require continued exploration. This study underscores the need to improve systematic screening to this high risk community in order to detect sight threatening disease at a time when therapy can be most beneficial.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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