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Racial and Ethnic Disparities in Risk for Adverse Ocular Events in Patients With Diabetic Retinopathy.

Clement C Anozie1, Victor F Cox2, Malcolm T Wiseman3

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Black and Hispanic patients with diabetic retinopathy (DR) face significantly higher risks of adverse visual outcomes like blindness and diabetic macular edema (DME). These disparities highlight the need for targeted interventions to ensure equitable care for all racial and ethnic groups.

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Area of Science:

  • Ophthalmology
  • Public Health
  • Health Disparities

Background:

  • Diabetic retinopathy (DR) is a leading cause of vision loss in the United States.
  • Identifying racial and ethnic disparities in DR complications is crucial for developing equitable health interventions.
  • Understanding these disparities is essential for improving patient outcomes and reducing blindness.

Purpose of the Study:

  • To assess racial and ethnic disparities in the risk of adverse visual outcomes among patients diagnosed with diabetic retinopathy (DR).
  • To analyze the incidence of blindness, vitreous hemorrhage (VH), tractional retinal detachment (TRD), and diabetic macular edema (DME) within 1 and 5 years post-diagnosis.
  • To provide data for targeted public health interventions aimed at reducing disparities in DR care.

Main Methods:

  • Retrospective cohort study utilizing deidentified electronic medical records.
  • Analysis of 627,434 patients diagnosed with DR between 2005 and 2025, stratified by race and ethnicity.
  • Primary outcomes included the incidence of blindness, VH, TRD, and DME within 1-year and 5-year follow-up periods.

Main Results:

  • Black patients showed significantly higher risks for all studied adverse visual outcomes compared to non-Black patients.
  • Hispanic patients also exhibited elevated risks for blindness, VH, TRD, and DME compared to non-Hispanic patients.
  • Risk ratios for adverse outcomes ranged from 1.15 to 2.52, indicating persistent disparities across different time points and conditions.

Conclusions:

  • Significant racial and ethnic disparities exist in adverse visual outcomes for patients with diabetic retinopathy.
  • Black and Hispanic populations face disproportionately higher risks of severe complications, even when controlling for disease severity.
  • Findings underscore the need for targeted public health strategies to address and mitigate these disparities in DR care.