Purpose:
To evaluate the risk factors for developing Proliferative diabetic retinopathy (PDR) in a high risk Latino American population.
Methods:
A total of 1115 patients with diabetes presenting to the Los Angeles County University of Southern California (LAC+USC) medical centre were enrolled in this prospective case control study. Medical and ophthalmic history, laboratory parameters, ophthalmic examination findings and imaging (color photographs and OCT) for each individual were collected. Complete data was available for 925 (82.9%) patients and this subset was used for subsequent analysis. Univariate and multivariate logistic regression analysis was performed to study the effect of various risk factors, using PDR as a dependent variable. Analyses were performed using statistical software (SPSS for windows version 18.0; SPSS Science, Chicago, IL).
Results:
The mean age of patients without PDR was 56.92 (SD; 10.14) years, while that of patients with PDR was 57.15 (SD; 9.84) years. Parameters that conferred a statistically significant increased risk for PDR in the multivariate model included gender (men were at higher risk: odds ratio (OR), 3.00; 95% CI, 2.13 - 4.22), insulin use (OR, 2.19; 95% CI, 1.53 - 3.15), history of hypertension (OR, 2.19; 95% CI, 1.57 - 3.05), and duration (>30 years versus <10 years) of diabetes (OR, 6.49; 95%CI, 2.29 - 18.46). Interestingly, smoking, glycosylated hemoglobin levels, creatinine levels, cholesterol levels, and history of previous ocular surgery did not independently influence development of PDR in this cohort (Table 1).
Conclusions:
In this case-control study in a Latino population, duration of diabetes was the strongest risk factor for the development of PDR followed by male gender, hypertension, and insulin use. Interestingly, smoking and glycosylated hemoglobin levels did not confer additional significant risk in this cohort.
Keywords: diabetic retinopathy • diabetes