Racial disparities in the screening and treatment of diabetic retinopathy
Abstract
Diabetic retinopathy is a progressive disease and primary retinal vascular complication of diabetes mellitus, the third leading cause of blindness in the United States. Racial and ethnic minorities are more likely to suffer from diabetic retinopathy and diabetic macular edema, and typically undergo less screening. Lack of screening is due to a variety of factors, such as patient, provider, and institutional barriers. Due to the disparity in screening, minorities often present with more advanced stages of diabetic eye disease. As the minority population increases, the burden of treatment for these patients will also increase. It is imperative to understand the barriers and social determinants of health limiting visual outcomes in minority populations. Diabetic retinopathy and its complications are often preventable if detected and treated early. Advances in screening technology and intravitreal anti-VEGF injections have changed the landscape in preventing vision loss in diabetic patients.
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African-American patients are 4 times more likely to present with vision loss as compared to non-Hispanic Whites.
“For example, African-American patients are three times more likely to present with diabetic macular edema (DME), 1.6 times more likely to present with vision-threatening diabetic retinopathy, and 4 times more likely to present with vision loss as compared to non-Hispanic Whites9–12.”
From Autonomous AI-assisted diabetic retinopathy screening at primary care is associated with increased presentation to eye care by at risk patients (2026) · cites this paper as [9]
African-American patients are three times more likely to present with diabetic macular edema (DME) as compared to non-Hispanic Whites.
“For example, African-American patients are three times more likely to present with diabetic macular edema (DME), 1.6 times more likely to present with vision-threatening diabetic retinopathy, and 4 times more likely to present with vision loss as compared to non-Hispanic Whites9–12.”
From Autonomous AI-assisted diabetic retinopathy screening at primary care is associated with increased presentation to eye care by at risk patients (2026) · cites this paper as [9]
African-American patients are 1.6 times more likely to present with vision-threatening diabetic retinopathy as compared to non-Hispanic Whites.
“For example, African-American patients are three times more likely to present with diabetic macular edema (DME), 1.6 times more likely to present with vision-threatening diabetic retinopathy, and 4 times more likely to present with vision loss as compared to non-Hispanic Whites9–12.”
From Autonomous AI-assisted diabetic retinopathy screening at primary care is associated with increased presentation to eye care by at risk patients (2026) · cites this paper as [9]
Cites
Prevalence of Diabetic Retinopathy in the United States, 2005-2008
Zhang, X., Saaddine, J. B., Chou, C.-F., Cotch, M. F., Cheng, Y. J., Geiss, L. S., Gregg, E. W., Albright, A. L., Klein, B. E. K., & Klein, R. (2010) · JAMA · doi:10.1001/jama.2010.1111 · Cited by 1,196 · see citing works
Prevalence of and Risk Factors for Diabetic Macular Edema in the United States
Varma, R., Bressler, N. M., Doan, Q. V., Gleeson, M., Danese, M., Bower, J. K., Selvin, E., Dolan, C., Fine, J., Colman, S., et al. (2014) · JAMA Ophthalmology · doi:10.1001/jamaophthalmol.2014.2854 · Cited by 423 · see citing works
Disparities in A1C Levels Between Hispanic and Non-Hispanic White Adults With Diabetes
Kirk, J. K., Passmore, L. V., Bell, R. A., Narayan, K. M. V., D'Agostino, R. B., Arcury, T. A., & Quandt, S. A. (2008) · Diabetes Care · doi:10.2337/dc07-0382 · Cited by 167 · see citing works
Diabetes and Diabetic Retinopathy in a Mexican-American Population
West, S. K., Klein, R., Rodriguez, J., Muñoz, B., Broman, A. T., Sanchez, R., & Snyder, R. (2001) · Diabetes Care · doi:10.2337/diacare.24.7.1204 · Cited by 160 · see citing works
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Patel, D., Ananthakrishnan, A., Lin, T., Channa, R., Liu, T. Y. A., & Wolf, R. M. (2022) · Journal of Clinical Medicine · doi:10.3390/jcm11237120 · Cited by 43 · see citing works
Leong, A., Wolf, R. M., Channa, R., Wang, J., Lehmann, H., Abramoff, M. D., & Liu, T. Y. A. (2026) · npj Digital Medicine · doi:10.1038/s41746-026-02460-5 · Cited by 3 · see citing works
- Authors
- Coney, J. M., & Scott, A. W.
- Affiliations
- Johns Hopkins University (US)
- Corresponding author
- Coney, Joseph M.
- Venue
- Journal of the National Medical Association
- Publisher
- Elsevier BV
- Published
- 2022-04
- Volume
- 114
- Issue
- 2
- Pages
- 171-181
- ISSN
- 0027-9684 (ISSN-L)
- OpenAlex
- W4210378893
- Cited by
- 53
- References
- 4
- Citations by year
- 2026: 15 · 2025: 12 · 2024: 14 · 2023: 8 · 2022: 4
- FWCI
- 8.48
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of the National Medical Association (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Ophthalmology › Retinal Diseases and Treatments
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Retinal Imaging and Analysis
- Health Sciences › Medicine › Ophthalmology › Glaucoma and retinal disorders
- Keywords
- diabetic retinopathy, racial disparities, ethnic minorities, diabetic macular edema, vision screening, barriers to care, social determinants of health, anti-VEGF therapy, blindness prevention, diabetes mellitus
- MeSH terms
- Diabetes Mellitus, Diabetic Retinopathy, Humans, Macular Edema, Mass Screening, United States, Angiogenesis Inhibitors, Racial Groups
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