Abstract
Purpose :
To investigate the demographic disparities in diabetic retinopathy (DR) using patient data from Massachusetts Eye and Ear to better understand the disease burden and inform of DR screening strategies.
Methods :
We matched patients with reliable (signal strength ≥ 6) macular optical coherence tomography scans (Cirrus) between 2016 and 2023 with their International Statistical Classification of Diseases (ICD, 10th version) codes. All eyes were then categorized into normal, non-proliferative diabetic retinopathy (NPDR) and PDR. The normal eyes were determined as patients who have an OCT scan but do not have ICD code records. For each eye, the last OCT scan was selected, and we randomly selected one eye per patient when both eyes were available. We applied multivariable logistic regression to associate demographic parameters, including age, gender, race, and ethnicity, with DR stages. The odds ratio was used to quantify the disease burden for each demographic group.
Results :
19,477 patients were included in our study. The average age is 63.8 ± 18.3 years. The demographic group distributions are as follows: female: 56.4%, male: 43.6%; White: 80.9%, Black: 12.3%, Asian: 6.6%, American Indian or Alaska Native: 0.2%; Ethnicity: Non-Hispanic: 96.4%; Hispanic: 3.6%, 5.1% and 3.3% of the patients were normal, NPDR and PDR, respectively. Males, Blacks, and Hispanics have significantly (p < 0.001) higher NPDR (6.3% vs. 4.2%; 9.9% vs. 4.3%; 7.4% vs. 5.0%) and PDR (3.9% vs. 2.8%; 6.4% vs. 2.9%; 6.0% vs. 3.2%) prevalence compared with females, Whites and non-Hispanics, respectively (Figure 1). Having either NPDR or PDR (Figure 2), males are 1.55 times the odds of females, Black patients are 2.66 times the odds of White patients, and Hispanic patients are 1.95 times the odds of non-Hispanics. For having NPDR vs normal, males are 1.59 times the odds of females, Black patients are 2.80 times the odds of White patients, and Hispanic patients are 1.90 times the odds of non-Hispanic patients. For having PDR vs normal, males are 1.49 times the odds of females, Black patients are 2.50 times the odds of White patients, and Hispanic patients are 2.00 times the odds of non-Hispanic. All odds ratios were statistically significant with p values < 0.001.
Conclusions :
Male, Black, and Hispanic patients are more likely to have diabetic retinopathy in comparison to female, White, and non-Hispanic patients, respectively.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.