July 2018
Volume 59, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2018
Are Person- and Areal-Level Socio-Economic Status Asoosciated With the Onset and Progression of Diabetic Retinopathy?
Author Affiliations & Notes
  • Ecosse Luc Lamoureux
    Singapore Eye Research Institute, Singapore, SINGAPORE, Singapore
    Duke-NUS Medical School, Singapore, SINGAPORE, Singapore
  • Ling-Jun Li
    Singapore Eye Research Institute, Singapore, SINGAPORE, Singapore
    Division of Obstetrics and Gynecology, KK Women’s and Children’s Hospital, Singapore, SINGAPORE, Singapore
  • Wah Win
    Duke-NUS Medical School, Singapore, SINGAPORE, Singapore
  • Alfred TL Gan
    Singapore Eye Research Institute, Singapore, SINGAPORE, Singapore
  • Ryan Man
    Singapore Eye Research Institute, Singapore, SINGAPORE, Singapore
    Duke-NUS Medical School, Singapore, SINGAPORE, Singapore
  • Quang duc nguyen
    Singapore Eye Research Institute, Singapore, SINGAPORE, Singapore
  • Eva Fenwick
    Singapore Eye Research Institute, Singapore, SINGAPORE, Singapore
    Duke-NUS Medical School, Singapore, SINGAPORE, Singapore
  • Preeti Gupta
    Singapore Eye Research Institute, Singapore, SINGAPORE, Singapore
  • Charumathi Sabanayagam
    Singapore Eye Research Institute, Singapore, SINGAPORE, Singapore
    Duke-NUS Medical School, Singapore, SINGAPORE, Singapore
  • Neelam Kumari
    Singapore Eye Research Institute, Singapore, SINGAPORE, Singapore
    Singapore National Eye Centre, Singapore, SINGAPORE, Singapore
  • Jie-Jin Wang
    Singapore Eye Research Institute, Singapore, SINGAPORE, Singapore
    Duke-NUS Medical School, Singapore, SINGAPORE, Singapore
  • Paul Mitchell
    Centre for Vision Research, Department of Ophthalmology and the Westmead Institute, University of Sydney, Sydney, New South Wales, Australia , Sydney, New South Wales, Australia
  • Ching-Yu Cheng
    Singapore Eye Research Institute, Singapore, SINGAPORE, Singapore
    Singapore National Eye Centre, Singapore, SINGAPORE, Singapore
  • Tien Yin Wong
    Singapore Eye Research Institute, Singapore, SINGAPORE, Singapore
    Singapore National Eye Centre, Singapore, SINGAPORE, Singapore
  • Footnotes
    Commercial Relationships   Ecosse Lamoureux, None; Ling-Jun Li, None; Wah Win, None; Alfred Gan, None; Ryan Man, None; Quang duc nguyen, None; Eva Fenwick, None; Preeti Gupta, None; Charumathi Sabanayagam, None; Neelam Kumari, None; Jie-Jin Wang, None; Paul Mitchell, None; Ching-Yu Cheng, None; Tien Yin Wong, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2018, Vol.59, 2601. doi:
  • Views
  • Share
  • Tools
    • Alerts
      ×
      This feature is available to authenticated users only.
      Sign In or Create an Account ×
    • Get Citation

      Ecosse Luc Lamoureux, Ling-Jun Li, Wah Win, Alfred TL Gan, Ryan Man, Quang duc nguyen, Eva Fenwick, Preeti Gupta, Charumathi Sabanayagam, Neelam Kumari, Jie-Jin Wang, Paul Mitchell, Ching-Yu Cheng, Tien Yin Wong; Are Person- and Areal-Level Socio-Economic Status Asoosciated With the Onset and Progression of Diabetic Retinopathy?
      . Invest. Ophthalmol. Vis. Sci. 2018;59(9):2601.

      Download citation file:


      © ARVO (1962-2015); The Authors (2016-present)

      ×
  • Supplements
Abstract

Purpose : Diabetic retinopathy (DR), a leading cause of vision loss, has been equivocally linked with poor socio-economic status (SES) but longitudinal data are rare. We investigated the impact of person- and areal-level SES on the onset and progression of DR in a multiethnic Asian cohort.

Methods : From the Singapore Epidemiology of Eye Diseases Study, a population-based cohort study, we included 1189 Malays and Indians (mean age [SD]:58.9 [9.1] years, 50.6% female) with diabetes, SES data, and gradable fundus photos at baseline and follow-up visits (mean follow-up duration: 6.2 [0.9] yr). Person-level SES (PLSES) parameters were assessed using education (≤6yr/>6), monthly income (<SG$2000/≥2000) and residence (£2 rooms/>2) data. Areal-level SES (ALSES) was assessed using a published socio-economic disadvantage index, created with 12 variables from the 2010 Singapore population census. A high score indicated poor ALSES. DR was categorized as none, minimal, mild, moderate and severe. Incident DR was defined as none at baseline but at least minimal at follow-up; and DR progression as at least a 2-step increase in severity at follow-up from any DR initially. Modified poisson regression models (MPRMs) estimated the longitudinal relationship between PLSES and ALSES and the onset and progression of DR, adjusted for traditional DR risk factors.

Results : Of the 1189 participants, 769 (64.7%), 942 (80.4%), and 91 (7.7%) had low education; monthly income; and lived in small public flats, respectively. The median ALSES score was 103.7 [range 79-120]. At follow-up, 157/834 (18.8%) and 94/355 (26.5%) participants developed DR incidence and progression, respectively. In MPRMs, every ALSES SD increase was independently associated with a 32% higher risk of DR incidence (RR [95% CI]: 1.32 [1.14-1.53]). Similar risks were found in Malays (1.43[ 1.02-2.00]) and Indians (1.27 [1.01-1.60]). For PLSES, low monthly income (1.73 [1.06-2.83]) was significantly associated with incident DR but not low education (0.74 [0.51-1.08]) or living in small public flats (1.63 [0.88-3.04). No associations were found for SES measures with DR progression.

Conclusions : Low income and overall areal SES significant increase the risks of incident DR in two large ethnic groups in Singapore. Strategies targeting those with diabetes with low income and living in socio economically challenged areas may prevent the onset of DR.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.

×
×

This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.

×