Drew/UCLA Medical Education Program, Los Angeles, CA, USA.
J Diabetes Complications. 2009 Nov-Dec;23(6):371-5. doi: 10.1016/j.jdiacomp.2008.05.001. Epub 2008 Jul 3.
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).
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.
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).
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.
本研究旨在通过眼底照相（FP）和荧光素血管造影（FA）所显示的特征，描述拉丁裔与非裔美国人糖尿病性视网膜病变（DR）表型的差异。
这是对 1998 年 1 月至 2005 年 3 月期间来自 King-Drew 医疗中心眼科诊所的 203 例成年拉丁裔和非裔美国糖尿病患者的回顾性图表审查。收集了包括 HbA（1c）和肾功能在内的全身危险因素数据。根据早期糖尿病视网膜病变研究（ETDRS）标准对 FP 和 FA 进行分析和分级。进行统计学分析以确定特定病变类型是否更具特定种族特征。
两组间的性别、年龄、平均微量白蛋白/肌酐比值（ACR）和平均 HbA（1c）值无显著差异。两组均存在较高的临床显著黄斑水肿（CSME），包括局灶性或弥漫性（44%的拉丁裔和 46%的非裔美国人），且整体 DR 分级相似。然而，在对个别病变进行分析时，发现拉丁裔人群中更常见累及更大视网膜区域的视网膜内出血（P=.046）。
尽管年龄和血糖控制相当的拉丁裔和非裔美国人发生 CSME 和增殖性视网膜病变的风险相同，但拉丁裔人群可能更易发生以视网膜内出血外渗为特征的特定 DR 表型，这与不良预后相关。进一步的前瞻性研究可能揭示与预后和治疗相关的种族差异。
