June 2023
Volume 64, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2023
Proliferative Diabetic Retinopathy Disproportionately Impacts Distressed Communities
Author Affiliations & Notes
  • Akua Frimpong
    Ophthalmology, University of Vermont Larner College of Medicine, Burlington, Vermont, United States
    Ophthalmology, Yale School of Medicine, New Haven, Connecticut, United States
  • Christina Jayaraj
    Ophthalmology, Yale School of Medicine, New Haven, Connecticut, United States
  • Brittany Assanah
    Ophthalmology, Yale School of Medicine, New Haven, Connecticut, United States
  • Elijah Demb
    University of Connecticut, Storrs, Connecticut, United States
  • Ming-Chen Lu
    Ophthalmology, University of Michigan Michigan Medicine, Ann Arbor, Michigan, United States
  • June Weiss
    Ophthalmology, Yale School of Medicine, New Haven, Connecticut, United States
  • Kristen Harris Nwanyanwu
    Ophthalmology, Yale School of Medicine, New Haven, Connecticut, United States
  • Footnotes
    Commercial Relationships   Akua Frimpong None; Christina Jayaraj None; Brittany Assanah None; Elijah Demb None; Ming-Chen Lu None; June Weiss None; Kristen Nwanyanwu Genetech , Code C (Consultant/Contractor)
  • Footnotes
    Support  NONE
Investigative Ophthalmology & Visual Science June 2023, Vol.64, 3738. doi:
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      Akua Frimpong, Christina Jayaraj, Brittany Assanah, Elijah Demb, Ming-Chen Lu, June Weiss, Kristen Harris Nwanyanwu; Proliferative Diabetic Retinopathy Disproportionately Impacts Distressed Communities. Invest. Ophthalmol. Vis. Sci. 2023;64(8):3738.

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

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Abstract

Purpose : To determine if any association exists between the geographic distribution of participants scored by the Distressed Communities Index (DCI) and retinopathy disease progression.

Methods : We collected data from electronic medical records of participants aged 18 and older diagnosed with non-proliferative diabetic retinopathy (NPDR) at an initial ophthalmology visit. We identified participants whose disease progressed to PDR throughout follow-up visits. The DCI, a measure of the economic well-being of communities, was assigned based on participants' zip codes. The DCI score was compared between participants whose disease progressed and those whose disease did not progress using a 2-sample t-test. Logistic regression was used to test the independent association of the DCI ranking system and the probability of diabetic retinopathy progression. Outcomes were reported as odds ratios (OR) with 95% confidence intervals (CI).

Results : Among 1,365 participants, 137 (10%) developed PDR within the study's seven-year timeframe. Of the 137, 54% were males, 46% were aged 65 and older, 35% identified as White or Caucasian and 34% identified as Black or African American. Those whose disease progressed to PDR had a significantly worse average DCI score compared to those whose disease did not progress (64 [SD=26] vs. 58 [SD=27], p=.014). Based on DCI rankings, 63% of the 137 participants lived in "at-risk and distressed" neighborhoods. Seventy percent of participants that progressed to PDR and identified as Black or African American lived within the most disadvantaged quintile. This is 10% greater than those who identified as White or Caucasians. For a 10-unit increase in DCI score, the odds of progressing to PDR increased by 9.4% after adjustment for age and race (OR=1.094, 95% CI=1.019-1.176, p=.013).

Conclusions : Participants who developed PDR were more likely to live in disadvantaged neighborhoods. Determining the socioeconomic distress levels within communities and using geographic mapping data may help identify populations at higher risk of retinal disease progression. Further research can position healthcare professionals to implement and evaluate early screening interventions and provide better resources for at-risk populations.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.

 

 

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