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Roberta McKean-Cowdin, Ge Wen, Chunyi Hsu, Mina Torres, Ronald Klein, Stanley Paul Azen, Rohit Varma, Chinese American Eye Study; Prevalence of Diabetic Retinopathy in Adult Chinese Americans: The Chinese American Eye Study (CHES). Invest. Ophthalmol. Vis. Sci. 2014;55(13):5340.
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© ARVO (1962-2015); The Authors (2016-present)
To characterize the prevalence of diabetic retinopathy (DR) by severity of disease and duration of diabetes in a population-based sample of Chinese Americans residing in Monterey Park, Los Angeles County, California.
A population-based, cross-sectional study of Chinese Americans, 50 years of age and older, was completed. Data were obtained through in-person interviews and a comprehensive ophthalmologic examination. All participants diagnosed with diabetes underwent stereoscopic fundus photography in 7 standard Early Treatment Diabetic Retinopathy Study fields. Photographs were graded in a masked manner using a modified Airlie House Classification System to assess presence and severity of DR. Prevalence of any DR, non-proliferative DR (NPDR), proliferative DR (PDR) and 95% confidence intervals (95%CIs) were calculated overall, by age, gender, and duration of diabetes. Differences across groups were evaluated using chi-square tests.
A total of 4,582 participants completed the clinical examination, of whom 736 (16.1%) were identified with Type 2 Diabetes Mellitus (T2DM). Fundus photographs were gradable for 665 participants (90.4%). Prevalence among diabetic participants was 35.8% (95% CI: 32.1, 39.6) for any DR, 1.7% (95% CI: 0.8, 2.9) for severe NPDR and 2.4% (95% CI: 1.4, 3.9) for PDR. Increasing duration of diabetes was associated with increasing prevalence of any DR (P-trend <0.0001) and with increasing prevalence for every severity level of DR (P-trend<0.05). The prevalence of any DR was 2 times greater in participants diagnosed with diabetes 15 or more years in the past compared to those who were newly diagnosed and 10 times greater in participants with PDR. History of use of oral hypoglycemic agents with or without dietary modifications was the most frequent treatment for T2DM among participants with any DR or by severity of DR. The presence and severity of DR was similar in males and females.
Consistent with data from other racial/ethnic groups, the prevalence of DR in Chinese Americans in CHES increased significantly with longer duration of diabetes. Our data indicate that the prevalence of DR in Chinese Americans is low compared to the prevalence of DR found in Chinese residing in rural northern China, overall and by duration of diabetes.
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