Diabetic retinopathy in a black population - The Barbados Eye Study

Objective: The distribution of diabetic retinopathy in black populations is largely unknown. The authors present retinopathy data from the predominate ly black participants of the Barbados Eye Study (BES). Design and Participants: Prevalence study of 4631 participants based on a r andom sample of the Barbados population 40 to 84 years of age (84% particip ation). Main Outcome Measures: Diabetes was defined as self-reported history of phy sician-diagnosed diabetes or glycosylated hemoglobin greater than 10% (>2 s tandard deviations above the population mean of persons without a diabetes history). Retinopathy was assessed by independent gradings of 30 degrees co lor stereo fundus photographs of the disc and macula. Results: Diabetes was present in 19.4% of black (n = 4314), 15.2% of mixed (black and white; n = 184), and 7.5% of white/other (n = 133) self-reported racial groups. In the black/mixed population, regardless of diabetes statu s, the prevalence of retinopathy was 5.9%. In the 636 black and mixed parti cipants with diabetes, the prevalence of retinopathy was 28.5%: 19.8% had m inimum changes, 7.7% had moderate changes, and 0.9% had severe retinopathy. Clinically significant macular edema (CSME) was found in 8.6% of those wit h diabetes. Conclusions: In the population of African origin, approximately 1 in 17 per sons had retinopathy. Among those with diabetes, 28.5% had retinopathy and 8.6% had CSME. These results highlight the clinical and public health relev ance of diabetic retinopathy in the black population.