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A Hennis, SY Wu, B Nemesure, L Hyman, A Schachat, MC LeskeBarbados Eye Studies Group; Incident Diabetic Retinopathy in the Barbados Eye Study . Invest. Ophthalmol. Vis. Sci. 2002;43(13):4380.
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Purpose:To examine the 4-year incidence and risk factors for diabetic retinopathy (DR) among black participants with diabetes in the Barbados Eye Studies (BES). Methods: 410 persons with diabetes mellitus (DM) at baseline were re-evaluated for incidence or progression of DR by standardized protocol, which included an interview, anthropometric, blood pressure (BP), ocular measurements and fundus photography. Associations were evaluated by logistic regression analyses. Results: After 4 years, 94 of 306 (30.7%, 95% CI: 25.6-36.2%) persons unaffected at baseline developed incident DR, chiefly with features of microaneurysms (70%) and hemorrhages (56%). Based on diagnosis at baseline, incident DR was observed in 32.7% and 20.9% of previously and newly diagnosed DM, respectively. Clinically significant macular edema (CSME) developed in 16 (4.5%) of 352 individuals unaffected at baseline. Seven (6.9%) of the 101 persons with minimum or moderate DR at baseline progressed to proliferative DR. Women tended to have higher cumulative incidence of DR than men (32.5% vs. 27.5%). Age-specific incidence declined from 36.2% at age 40-49 years, to 28.8% and 26.3% over the subsequent 2 decades, increasing to 38.2% among those ≥70 years. Risk factors for DR included increased systolic BP (relative risk (RR)=1.15 (1.02-1.29) per 10 mmHg increase), use of oral hypoglycemics (RR=2.5 (1.4-4.5)) and insulin (RR=6.1 (1.7-22.1)) (vs. no treatment or diet only), and elevated glycated hemoglobin (GHb) (RR=5.5 (2.3-13.2)) (GHb ≷11.5% vs. GHb ≤8%). Conclusions: High rates of incident DR were evident in the black BES population, known to have high rates of DM. Interventions aimed at optimal glycemic and blood pressure control are important to prevent visual loss due to DR in this population.
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