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Diabetic Retinopathy in a Multi-ethnic Cohort in the United States

Published:October 05, 2005DOI:https://doi.org/10.1016/j.ajo.2005.08.063

      Purpose

      To describe the prevalence and risk factors of diabetic retinopathy in a multi-ethnic US population of whites, blacks, hispanics, and chinese.

      Design

      Cross-sectional study of 778 individuals from ages 45 to 85 years with diabetes, participating in the Multi-Ethnic Study of Atherosclerosis (MESA).

      Methods

      Retinal photographs were obtained with a 45° nonmydriatic digital fundus camera. Presence and severity of diabetic retinopathy were graded at a central reading center on the basis of a modification of the Airlie House classification system. All participants underwent a standardized interview, examination, and laboratory investigations.

      Results

      In this population with diabetes, the prevalence of any retinopathy was 33.2% and macular edema 9.0%. The prevalence of any diabetic retinopathy and macular edema was significantly higher in blacks (36.7% and 11.1%) and hispanics (37.4% and 10.7%) than in whites (24.8% and 2.7%) and chinese (25.7% and 8.9%) (P = .01 and P = .007, comparing racial/ethnic differences for retinopathy and macular edema, respectively). Significant independent predictors of any retinopathy were longer duration of diabetes, higher fasting serum glucose, use of diabetic oral medication or insulin, and greater waist-hip ratio. Race was not an independent predictor of any retinopathy.

      Conclusions

      This study provides contemporary data on the prevalence of and risk factors for diabetic retinopathy among whites, blacks, hispanics, and chinese participating in the MESA.
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      Biography

      Tien Yin Wong, MD, PhD, is an Associate Professor in Ophthalmology at the Centre for Eye Research Australia, University of Melbourne, and a Retinal consultant at the Royal Victorian Eye and Ear Hospital. He has a PhD in Epidemiology from the Johns Hopkins University. His clinical and research interest is in retinal vascular diseases, including diabetic and hypertensive retinopathy. He is on the Editorial Board of the British Journal of Ophthalmology and IOVS.

      Linked Article

      • Diabetic Retinopathy: Challenges and Future Directions
        American Journal of OphthalmologyVol. 141Issue 3
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          In this issue of the Journal, Wong and associates1 present baseline retinopathy data on a multi-ethnic cohort of persons with diabetes mellitus who were aged 43 to 85 years and who had no clinical evidence of cardiovascular disease. Their study points out that one of every three persons in this cohort with any type of diabetes mellitus has diabetic retinopathy. The study suggests that although blacks and hispanics had higher prevalences of diabetic retinopathy compared with non-Hispanic whites and Chinese Americans, after adjustment for the traditional risk factors, ethnicity was not associated independently with a greater risk of diabetic retinopathy.
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