Abstract
Purpose::
The objective of this study is to delineate the difference in the phenotype of diabetic retinopathy (DR) between Blacks and Latinos using characteristics shown on fundus photography and fluorescein angiography. Recognition of the differences in DR presentation between Blacks and Latinos may elucidate the pathogenesis of diabetic retinopathy, help to determine the prognosis of DR in these two ethnic groups and tailor management according to racial profile.
Methods::
This is a retrospective study of medical charts from the Eye Clinic at the King-Drew Medical Center from January 1998 to March 2005. Charts from Type 1 or 2 diabetics of Black or Latino origin were reviewed. Systemic data such as Hemoglobin A1C (HbA1C) levels were collected. Fundus photography and wide field fluorescein angiography were analyzed for each eye which was graded according to ETDRS criteria. Statistical analysis to determine whether a given lesion type was more characteristic of a particular racial group was performed.
Results::
358 eyes of 199 patients were included in this analysis, 80% of the patients were Latino and 20% were Black. Gender and age (average age of 55 years for the Latinos and 58 years for the Blacks) were not significantly different between groups. Average HbA1C was 9.9% for the Latino group and 9.8% for the Black group, which was not significantly different. The presence of clinically significant macular edema (CSME), focal or diffuse, was very high in both groups, 44% in the Latinos and 46% in the Blacks, and the overall grade of DR was similar with formal comparative analysis. However, upon individual lesion analysis, the Latinos were noted to have a greater prevalence and severity of intraretinal hemorrhages (p<0.07).
Conclusions::
Although Latinos and Blacks of comparable age and glycemic control are equally at risk of macular edema and proliferative retinopathy, Latinos may be at greater risk of a specific phenotype of DR characterized by extravasation of intraretinal hemorrhages which has been shown to be associated with a poor prognosis. Further prospective studies to compare the presentation of DR in Latinos versus Blacks may uncover racial differences which may have implications for prognosis and therapy.
Keywords: diabetic retinopathy