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Over a 6-year period, 56.1% of African Americans with type 1 diabetes and retinopathy showed progression of their eye disease. The report is published in the Archives of Ophthalmology for September. Poor glycemic and blood pressure control were identified as risk factors for progression.
The findings stem from a study of 483 subjects who were part of The New Jersey 725 cohort, which comprised African-American patients who were diagnosed with diabetes and treated with insulin before 30 years of age. The current cohort included only those with type 1 diabetes.
As part of the study, structured clinical interviews, ocular examinations, fundus photographs, and blood pressure measurements were taken at baseline and 6 years later.
"At the 6-year evaluation, 72.3% of the patients at risk for incidence of diabetic retinopathy had developed any diabetic retinopathy," report Dr. Monique S. Roy, from the University of Medicine and Dentistry in Newark, and Dr. Mahmoud Affouf, from Kean University in Union, both in New Jersey.
As noted, 56.1% of patients with baseline retinopathy showed disease progression, including 15.0% who progressed to proliferative retinopathy and 15.9% who developed macular edema.
High glycosylated hemoglobin levels at baseline and systemic hypertension were significant predictors of retinopathy progression and macular edema, the team found.
Older age, renal disease, and severe retinopathy all correlated with progression to proliferative retinopathy. For macular edema, the risk factors included older age, lower socioeconomic status, severe retinopathy, and high total cholesterol levels.
"Because glycemic and blood pressure control in this population are poor, measures to improve medical care and ensure regular dilated eye examinations to detect vision-threatening diabetic retinopathy may reduce morbidity from the disease," the authors conclude.
Arch Opthalmol 2006;124:1297-1306.
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