The Prevalence of Diabetic Retinopathy in Australian Adults with Self-Reported Diabetes

Abstract

Purpose To determine the prevalence of and factors associated with diabetic retinopathy (DR) among non-Indigenous and Indigenous Australian adults with self-reported diabetes. Design Population-based cross-sectional study. Participants Non-Indigenous Australians (50-98 years of age) and Indigenous Australians (40-92 years of age) with known diabetes. Methods Diabetes was determined based on self-report of previous diagnosis of the disease. Nonmydriatic fundus photographs were obtained of each eye and graded according to the modified Airlie House classification system. Main outcome measures Any DR, vision-threatening DR (VTDR), treatment coverage rates (proportion of participants with proliferative DR [PDR], clinically significant macular edema [CSME], or both who had evidence of retinal scatter and focal laser treatment). Results Four hundred thirty-one non-Indigenous Australians (13.9%) and 645 Indigenous Australians (37.1%) self-reported diabetes, of whom 93% (1004/1076) had retinal images that were gradable for DR. The sampling weight-adjusted prevalence of any DR and VTDR among non-Indigenous adults with self-reported diabetes was 28.5% (95% confidence interval [CI], 22.6-35.3) and 4.5% (95% CI, 2.6-7.9), respectively. Among adults 40 years of age and older, the sampling weight-adjusted prevalence of any DR and VTDR was 39.4% (95% CI, 33.1-46.1) and 9.5% (95% CI, 6.8-13.1), respectively. Longer diabetes duration was associated significantly with VTDR in the Indigenous Aus…