Ethnic disparities in progression rates for sight-threatening diabetic retinopathy in diabetic eye screening: a population-based retrospective cohort study

Olvera-Barrios, Abraham; Owen, Christopher G.; Anderson, John; Warwick, Alasdair N.; Chambers, Ryan; Bolter, Louis; Wu, Yue; Welikala, Roshan; Fajtl, Jiri; Barman, Sarah; Remagnino, Paolo; Chew, Emily Y.; Ferris, Frederick L.; Hingorani, Aroon D.; Sofat, Reecha; Lee, Aaron; Egan, Catherine; Tufail, Adnan; Rudnicka, Alicja R.

Abstract

IntroductionThe English Diabetic Eye Screening Programme (DESP) offers people living with diabetes (PLD) annual eye screening. We examined incidence and determinants of sight-threatening diabetic retinopathy (STDR) in a sociodemographically diverse multi-ethnic population.Research design and methodsNorth East London DESP cohort data (January 2012 to December 2021) with 137 591 PLD with no retinopathy, or non-STDR at baseline in one/both eyes, were used to calculate STDR incidence rates by sociodemographic factors, diabetes type, and duration. HR from Cox models examined associations with STDR.ResultsThere were 16 388 incident STDR cases over a median of 5.4 years (IQR 2.8-8.2; STDR rate 2.214, 95% CI 2.214 to 2.215 per 100 person-years). People with no retinopathy at baseline had a lower risk of sight-threatening diabetic retinopathy (STDR) compared with those with non-STDR in one eye (HR 3.03, 95% CI 2.91 to 3.15, pConclusionsEthnic disparities exist in a health system limited by capacity rather than patient economic circumstances. Diabetic retinopathy at first screen is a strong determinant of STDR development. By using basic demographic characteristics, screening programmes or clinical practices can stratify risk for sight-threatening diabetic retinopathy development.

Citation

Olvera-Barrios, A., Owen, C. G., Anderson, J., Warwick, A. N., Chambers, R., Bolter, L., …Rudnicka, A. R. (2023). Ethnic disparities in progression rates for sight-threatening diabetic retinopathy in diabetic eye screening: a population-based retrospective cohort study. BMJ Open Diabetes Research and Care, 11(6), Article e003683. https://doi.org/10.1136/bmjdrc-2023-003683

• Journal Article Type: Article
• Acceptance Date: Sep 8, 2023
• Online Publication Date: Nov 10, 2023
• Publication Date: Nov 1, 2023
• Deposit Date: Sep 13, 2023
• Publicly Available Date: Nov 15, 2023
• Journal: BMJ Open Diabetes Research and Care
• Electronic ISSN: 2052-4897
• Publisher: BMJ Publishing Group
• Peer Reviewed: Peer Reviewed
• Volume: 11
• Issue: 6
• Article Number: e003683
• DOI: https://doi.org/10.1136/bmjdrc-2023-003683
• Keywords: Ethnic Groups, Diabetic retinopathy, Blindness, Healthcare Disparities, Humans, Diabetic Retinopathy, Diabetes Mellitus, Mass Screening, Incidence, Retrospective Studies, London
• Public URL: https://durham-repository.worktribe.com/output/1736831
• PMID: 37949472