Indiana University School of Optometry, Bloomington, Indiana.
College of Health Solutions, Arizona State University, Phoenix, Arizona.
Optom Vis Sci. 2024 Jan 1;101(1):25-36. doi: 10.1097/OPX.0000000000002096. Epub 2024 Jan 8.
Suspected clinically significant macular edema (SCSME) from exudates differed among ethnic groups in our underserved population. African American and Asian subjects had higher prevalence than Hispanics and non-Hispanic Caucasians, from the same clinics. Men had higher prevalence than women. Highly elevated blood glucose was frequent and associated with SCSME.
We investigated the association between the presence of SCSME from exudates and hemoglobin A1c (HbA1c), as well as demographic factors such as age, sex, and ethnic group. Our population was underserved diabetic patients from the same geographic locations. Ethnic groups were White Hispanic, non-Hispanic Caucasian, African American, and Asian, with a high proportion of underrepresented minorities.
In a diabetic retinopathy screening study at four community clinics in Alameda County, California, nonmydriatic 45° color fundus images were collected from underserved diabetic subjects following the EyePACS imaging protocol. Images were analyzed for SCSME from exudates by two certified graders. Logistic regression assessed the association between SCSME from exudates and age, sex, ethnic group, and HbA1c.
Of 1997 subjects, 147 (7.36%) had SCSME from exudates. The mean ± standard deviation age was 53.4 ± 10.5 years. The mean ± standard deviation HbA1c level was 8.26 ± 2.04. Logistic regression analysis indicated a significant association between presence of SCSME from exudates and HbA1c levels (p<0.001), sex (p=0.027), and ethnicity (p=0.030). African Americans (odds ratio [OR], 1.63; 95% confidence interval [CI], 1.06 to 2.50; p=0.025) and Asians (OR, 1.63; 95% CI, 1.05 to 2.54; p=0.029) had a higher risk than Hispanics. After adjusting for ethnicity, sex, and age, the odds of developing SCSME from exudates increased by 26.5% with every 1% increase in HbA1c level (OR, 1.26; 95% CI, 1.18 to 1.36; p<0.001).
In our underserved population, many diabetic patients had very high HbA1c values. Ethnic background (African American > Asians > Hispanics), sex (male > female), and HbA1c level were strong indicators for identifying who is at increased risk of developing SCSME from exudates.
在我们服务不足的人群中，来自渗出物的疑似临床显著的黄斑水肿（SCSME）在不同种族之间存在差异。来自同一诊所的非裔美国人和亚洲人比西班牙裔和非西班牙裔白种人更常见。男性比女性更常见。高血糖很常见，且与 SCSME 相关。
我们研究了来自渗出物的 SCSME 的存在与血红蛋白 A1c（HbA1c）之间的关系，以及年龄、性别和种族等人口统计学因素。我们的人群是来自同一地理位置的服务不足的糖尿病患者。种族群体为白西班牙裔、非西班牙裔白种人、非裔美国人和亚洲人，少数族裔比例很高。
在加利福尼亚州阿拉米达县的四个社区诊所进行的糖尿病视网膜病变筛查研究中，根据 EyePACS 成像方案，从服务不足的糖尿病患者中收集了非散瞳 45°眼底彩色图像。两名认证分级员通过图像分析渗出物中 SCSME 的存在。Logistic 回归评估了渗出物中 SCSME 的存在与年龄、性别、种族和 HbA1c 之间的关系。
在 1997 名受试者中，有 147 名（7.36%）有渗出物引起的 SCSME。平均年龄±标准差为 53.4±10.5 岁。平均 HbA1c 水平±标准差为 8.26±2.04。Logistic 回归分析表明，渗出物中 SCSME 的存在与 HbA1c 水平（p<0.001）、性别（p=0.027）和种族（p=0.030）之间存在显著关联。非裔美国人（优势比[OR]，1.63；95%置信区间[CI]，1.06 至 2.50；p=0.025）和亚洲人（OR，1.63；95%CI，1.05 至 2.54；p=0.029）的风险高于西班牙裔。调整种族、性别和年龄后，HbA1c 水平每增加 1%，渗出物中 SCSME 的发生风险增加 26.5%（OR，1.26；95%CI，1.18 至 1.36；p<0.001）。
在我们服务不足的人群中，许多糖尿病患者的 HbA1c 值非常高。种族背景（非裔美国人>亚洲人>西班牙裔）、性别（男性>女性）和 HbA1c 水平是确定谁患渗出物 SCSME 风险增加的重要指标。
