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M. Torres, J. Chung, S. Azen, R. Klein, R. Varma, LALES Group; Risk Indicators Associated With 4-Year Incidence of Diabetic Retinopathy. The Los Angeles Latino Eye Study (LALES). Invest. Ophthalmol. Vis. Sci. 2010;51(13):2094.
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To determine the association between independent risk indicators and four-year incidence of any diabetic retinopathy (DR) in a population-based sample of adult Latinos.
The LALES is a longitudinal population-based cohort that examined the 4-year incidence of eye disease in Latinos age 40 and older. All participants underwent a standardized comprehensive ophthalmic examination, including a series of stereoscopic fundus photographs (7 standard Early Treatment Diabetic Retinopathy Study fields). Photographs were graded in a masked manner using a Modified Arlie House classification system to assess presence and severity of DR. Participants were considered at risk for developing any DR if diabetes mellitus was present and persons were free of DR at baseline. Risk Indicators (gender, age, use of insulin, Hba1c, random blood glucose, systolic and diastolic blood pressure, and duration of diabetes) were assessed to determine their relationship with incidence of any DR. Logistic regression procedures were used to calculate Odds ratios (OR) for the independent risk associated with development and progression of DR.
Of the 404 diabetic persons without DR at baseline, 114 (28.2%) developed incident of DR at the 4-year follow-up. Independent risk indicators associated with incident DR included, longer duration of diabetes mellitus (OR: 2.2), elevated levels of HbA1c (OR: 1.5), and an increase in the level of HbA1c from baseline to 4-year follow-up (OR 2.2).
Our data suggest that poor glycemic control and longer duration of diabetes mellitus are independently associated with higher incidence of DR in our Latino population. Maintaining good glycemic control continues to play an important role in the management of DR in Latinos.
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