Diabetic retinopathy in a black population: the Barbados Eye Study

ABSTRACT

OBJECTIVE: The distribution of diabetic retinopathy in black populations is largely unknown. The authors present retinopathy data from the predominantly black participants of the Barbados Eye Study (BES). DESIGN AND PARTICIPANTS: Prevalence study of 4631 participants based on a random sample of the Barbados population 40 to 84 years of age (84 percent participation). MAIN OUTCOME MEASURES: Diabetes was defined as self-reported history of physician-diagnosed diabetes or glycosylated hemoglobin greater than 10 percent (>2 standard deviations above the population mean of persons without a diabetes history). Retinopathy was assessed by independent grading of 30 degrees color stereo fundus photographs of the disc and macula. RESULTS: Diabetes was present in 19.4 percent of black (n = 4314), 15.2 percent of mixed (black and white, n = 184), and 7.5 percent of white/other (n = 133) self-reported racial groups. In the black/mixed population, regardless of diabetes status, the prevalence of retinopathy was 5.9 percent. In the 636 black and mixed participants with diabetes, the prevalence of retinopathy was 28.5 percent 19.8 percent had minimum changes, 7.7 percent had moderate changes, and 0.9 percent had severe retinopathy. Clinically significant macular edema (CSME) was found in 8.6 percent of those with diabetes. CONCLUSIONS: In the population of African origin, approximately 1 in 17 persons had retinopathy. Among those with diabetes, 28.5 percent had retinopathy and 8.6 percent had CSME. These results highlight the clinical and public health relevance of diabetic retinopathy in the black populaion.(AU)