Monique S. Roy, MD, professor, Ophthalmology Department, UMDNJ-New Jersey Medical School (NJMS). Not shown: Joan Skurnick, PhD, associate professor, Department of Preventive Medicine and Community Health, NJMS, and Department of Quantitative Methods, UMDNJ-School of Public Health.
Six-Year Incidence of Visual Loss in African Americans with Type 1 Diabetes Mellitus
bjective: To report the 6-year incidence of visual loss and associated risk factors in African Americans with type 1 diabetes mellitus.
Methods: African Americans with type 1 diabetes
(n = 483) who participated in the New Jersey 725 study were reexamined as part of a 6-year follow-up. Best-corrected visual acuity, a structured clinical interview, fundus photographs, and blood pressure measurements were obtained. The biological evaluation included blood and urine assays. Any visual loss was defined as a visual acuity of 20/40 or worse in the better eye, blindness as a visual acuity of 20/200 or worse in the better eye, and doubling of the visual angle (DVA) as the loss of 15 or more letters between the first and second visits.
Results: Over 6 years, 19 of 440 patients (4.3%) developed visual loss in the better eye, 3 of 472 patients (0.6%) became blind, 47 of 481 patients (9.8%) developed DVA in the better eye, and 65 of 481 (13.5%) developed DVA in either eye. Baseline older age, high glycosylated hemoglobin level, retinopathy severity, and proteinuria were characteristics significantly (P<.001 for all) and independently associated with DVA in either eye at follow-up.
Conclusions: The 6-year incidence of DVA in either eye (13.5%) is high in African Americans with type 1 diabetes. Baseline poor glycemic control, diabetic retinopathy severity, proteinuria, and older age are predictors of visual loss in this population.
Author Affiliations: The Institute of Ophthalmology and Visual Science (Dr Roy) and Department of Preventive Medicine & Community Health (Dr Skurnick), University of Medicine & Dentistry of New Jersey, New Jersey Medical School, Newark.
| Figure 1. Six-year incidence of visual loss (visual acuity [VA] of2 0/40 or worse in the better eye), blindness (VA of 20/200 or worse in the better eye), and doubling of the visual angle (DVA) in the better eye and in either eye according to age at baseline.
This abstract is published with permission from the Arch Ophthalmol, August 2007, Vol.125: pages 1061-1067; Copyright © 2007, American Medical Association. All rights reserved.