Centre for Vision Research, Westmead Institute for Medical Research, The University of Sydney, Sydney, New South Wales, Australia
South West Retina, Dept of Clinical Trials, Sydney, New South Wales, Australia.
BMJ Open. 2023 Feb 22;13(2):e055404. doi: 10.1136/bmjopen-2021-055404.
There are limited data on the influence of ethnicity on diabetic retinopathy (DR). We sought to determine the distribution of DR by ethnic group in Australia.
Clinic-based cross-sectional study.
Participants with diabetes in a defined geographical region of Sydney, Australia, who attended a tertiary retina referral clinic.
The study recruited 968 participants.
Participants underwent a medical interview and retinal photography and scanning.
DR was defined from two-field retinal photographs. Diabetic macular oedema (DMO) was defined from spectral domain optical coherence tomography (OCT-DMO). The main outcomes were any DR, proliferative DR (PDR), clinically significant macular oedema (CSME), OCT-DMO and sight-threatening DR (STDR).
There was high proportion of any DR (52.3%), PDR (6.3%), CSME (19.7%), OCT-DMO (28.9%) and STDR (31.5%) in people attending a tertiary retinal clinic. Participants of Oceanian ethnicity had the highest proportion of any DR and STDR (70.4% and 48.1%, respectively), while the lowest proportion was in participants of East Asian ethnicity (38.3% and 15.8%, respectively). Proportion of any DR and STDR in Europeans was 54.5% and 30.3%, respectively. Independent predictive factors for diabetic eye disease were ethnicity, longer duration of diabetes, higher glycated haemoglobin and higher blood pressure. Even after adjusting for risk factors, Oceanian ethnicity remained associated with twofold higher odds of any DR (adjusted OR 2.10, 95% CI 1.10 to 4.00) and all other forms of DR including STDR (adjusted OR 2.22, 95% CI 1.19 to 4.15).
In people attending a tertiary retinal clinic, the proportion of people with DR varies among ethnic groups. The high proportion in persons of Oceanian ethnicity suggests a need for targeted screening of this at-risk group. In addition to traditional risks factors, ethnicity may be an additional independent predictor of DR.
关于种族对糖尿病视网膜病变（DR）的影响，相关数据有限。我们旨在确定澳大利亚不同种族群体中 DR 的分布情况。
以诊所为基础的横断面研究。
参与者为澳大利亚悉尼一个特定地理区域的糖尿病患者，他们在一家三级视网膜转诊诊所就诊。
该研究共招募了 968 名参与者。
参与者接受了医疗访谈和视网膜摄影及扫描。
从双视野视网膜照片中确定 DR。应用频域光相干断层扫描（OCT-DMO）确定糖尿病黄斑水肿（DMO）。主要结局为任何 DR、增殖性 DR（PDR）、临床显著黄斑水肿（CSME）、OCT-DMO 和威胁视力的 DR（STDR）。
在一家三级视网膜诊所就诊的人群中，DR 的发生率很高，包括任何程度的 DR（52.3%）、PDR（6.3%）、CSME（19.7%）、OCT-DMO（28.9%）和 STDR（31.5%）。大洋洲裔人群的任何 DR 和 STDR 比例最高（分别为 70.4%和 48.1%），而东亚裔人群的比例最低（分别为 38.3%和 15.8%）。欧洲裔人群的任何 DR 和 STDR 比例分别为 54.5%和 30.3%。糖尿病眼病的独立预测因素为种族、糖尿病病程较长、糖化血红蛋白水平较高和血压较高。即使在调整了危险因素后，大洋洲裔人群的任何 DR 发生风险仍高出两倍（校正比值比 2.10，95%置信区间 1.10 至 4.00），且所有其他类型的 DR（包括 STDR）的发生风险也高出两倍（校正比值比 2.22，95%置信区间 1.19 至 4.15）。
在三级视网膜诊所就诊的人群中，不同种族群体的 DR 发生率不同。大洋洲裔人群的高发生率提示需要对该高危人群进行有针对性的筛查。除了传统的危险因素外，种族可能是 DR 的另一个独立预测因素。
