Comparison of diabetic retinopathy phenotype between Latinos and Blacks

Chen, Jessica L.; Luviano, Damien M.; Chen, John C.; Yu, Fei; Sarraf, David

doi:10.1016/j.jdiacomp.2008.05.001

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Volume 23, Issue 6 , Pages 371-375, November 2009

Comparison of diabetic retinopathy phenotype between Latinos and Blacks☆

Jessica L. Chen
- Drew/UCLA Medical Education Program, Los Angeles, CA, USA
Damien M. Luviano
- Department of Ophthalmology, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA
John C. Chen
- David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
Fei Yu
- Jules Stein Eye Institute at UCLA, Los Angeles, CA, USA
David Sarraf
- Department of Ophthalmology, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA
- Jules Stein Eye Institute at UCLA, Los Angeles, CA, USA
- Ophthalmology, Greater Los Angeles Veterans Administration Healthcare System, Los Angeles, CA, USA
- Corresponding author. Jules Stein Eye Institute, University of California, Los Angeles, Oph Box 957006, 1-165 JSEI, Los Angeles, CA 90095-7006, USA. Tel.: +1 310 794 7426; fax: +1 310 825 0441.

Received 17 September 2007; received in revised form 11 April 2008; accepted 8 May 2008. published online 04 July 2008.

Abstract

Objective

The objective of this study was to delineate the difference in the phenotype of diabetic retinopathy (DR) in Latinos versus Blacks using characteristics shown on fundus photography (FP) and fluorescein angiography (FA).

Research Design and Methods

This was a retrospective chart review of 203 adult Black and Latino diabetic patients from the King–Drew Medical Center eye clinic from January 1998 to March 2005. Systemic risk factors such as HbA_1c and kidney function data were collected. FP and FA were analyzed and graded according to Early Treatment of Diabetic Retinopathy Study criteria. Statistical analysis was performed to determine whether a given lesion type was more characteristic of a particular racial group.

Results

Gender, age, median microalbumin-to-creatinine ratio (ACR), and average HbA_1c values were not significantly different between the groups. The presence of clinically significant macular edema (CSME), focal or diffuse, was very high in both groups (44% in Latinos and 46% in Blacks), and the overall DR grades were similar. However, upon individual lesion analysis, the Latinos were noted to have more prevalent intraretinal hemorrhages involving a greater area of the retina (P=.046).

Conclusions

Although Latinos and Blacks of comparable age and glycemic control are equally at risk for CSME and proliferative retinopathy, Latinos may be at greater risk for a specific phenotype of DR characterized by extravasation of intraretinal hemorrhages, which is associated with poor prognosis. Further prospective studies may uncover racial differences that may have implications for prognosis and therapy.

Keywords: Diabetic retinopathy phenotype, Latino, Black