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M. S. Roy, J. Skurnick; Six-Year Incidence of Visual Loss in African-Americans With Type 1 Diabetes. Invest. Ophthalmol. Vis. Sci. 2007;48(13):5009.
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To report the 6-year incidence of visual loss and associated risk factors in African-Americans with type 1 insulin-dependent diabetes mellitus.
African-Americans with type 1 diabetes (n=483) who participated in the New Jersey 725 study were re-examined as part of a 6-year follow-up. Best-corrected visual acuity (VA) was measured using the Early Treatment Diabetic Retinopathy Study (EDTRS) protocol. A structured clinical interview, seven stereoscopic fundus photographs for severity of diabetic retinopathy (DR), and blood pressure measurements were obtained. Biological evaluation included blood and urine assays. Any visual loss was defined as VA <20/40 in the better eye, blindness as VA <20/200 in the better eye, and doubling of the visual angle (DVA) as the loss of >15 letters either in the better eye or in either eye between first and second visits.
Over the 6-year period, 19 (4.3%) of the 440 at-risk patients developed visual loss in the better eye, three (0.6%) became blind, 47(9.8%) developed DVA in the better eye, and 65(13.5%) DVA in either eye. Baseline older age, high glycosylated hemoglobin, increasing DR severity, and proteinuria were characteristics significantly and independently associated with DVA in either eye at follow-up.
Six-year incidence of DVA in either eye (13.5%) is high in African-Americans with type 1 diabetes. Baseline poor glycemic control, retinopathy severity, proteinuria, and older age are strong predictors of visual loss in this population.
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