Clinically significant macular edema in an underserved population: Association with demographic factors and hemoglobin A1c.

IF 1.6 4区医学 Q3 OPHTHALMOLOGY

Optometry and Vision Science Pub Date : 2024-01-01 Epub Date: 2024-01-08 DOI:10.1097/OPX.0000000000002096

Vamsi Parimi, Ann E Elsner, Thomas J Gast, Zhongxue Chen, Karthikeyan Baskaran, Mastour A Alhamami, Taras V Litvin, Glen Y Ozawa, Jorge A Cuadros

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Abstract

Significance: 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.

Purpose: 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.

Methods: 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.

Results: 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).

Conclusions: 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.

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在服务不足的人群中，黄斑水肿具有临床意义：与人口统计学因素和血红蛋白 A1c 的关系

意义重大：在我们服务不足的人群中，不同种族的渗出物引起的疑似有临床意义的黄斑水肿（SCSME）存在差异。在同一诊所中，非裔美国人和亚裔受试者的患病率高于西班牙裔和非西班牙裔白种人。男性发病率高于女性。目的：我们研究了渗出物中 SCSME 的存在与血红蛋白 A1c（HbA1c）以及年龄、性别和种族等人口统计学因素之间的关系。我们的研究对象是来自同一地区、服务不足的糖尿病患者。种族群体包括西班牙裔白人、非西班牙裔高加索人、非洲裔美国人和亚洲人，其中少数民族比例较高：在加利福尼亚州阿拉米达县的四家社区诊所进行的糖尿病视网膜病变筛查研究中，按照 EyePACS 成像方案从服务不足的糖尿病受试者中收集了非眼球驱动的 45° 彩色眼底图像。由两名经过认证的分级人员对图像进行分析，从渗出物中检测 SCSME。逻辑回归评估了渗出物 SCSME 与年龄、性别、种族和 HbA1c 之间的关联：在 1997 名受试者中，147 人（7.36%）患有渗出液 SCSME。平均（± 标准差）年龄为 53.4 ± 10.5 岁。HbA1c 平均值（标准差）为 8.26 ± 2.04。逻辑回归分析表明，渗出物中 SCSME 的存在与 HbA1c 水平之间存在显著关联（p 结论：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（非洲裔美国人 > 亚洲人 > 西班牙裔美国人）、性别（男性 > 女性）和 HbA1c 水平是确定哪些人因渗出物而罹患 SCSME 风险较高的有力指标。

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来源期刊

Optometry and Vision Science 医学-眼科学

CiteScore

2.80

自引率

7.10%

发文量

210

审稿时长

3-6 weeks

期刊介绍： Optometry and Vision Science is the monthly peer-reviewed scientific publication of the American Academy of Optometry, publishing original research since 1924. Optometry and Vision Science is an internationally recognized source for education and information on current discoveries in optometry, physiological optics, vision science, and related fields. The journal considers original contributions that advance clinical practice, vision science, and public health. Authors should remember that the journal reaches readers worldwide and their submissions should be relevant and of interest to a broad audience. Topical priorities include, but are not limited to: clinical and laboratory research, evidence-based reviews, contact lenses, ocular growth and refractive error development, eye movements, visual function and perception, biology of the eye and ocular disease, epidemiology and public health, biomedical optics and instrumentation, novel and important clinical observations and treatments, and optometric education.