Estimates of diabetic retinopathy (DR) incidence and progression may be lower than those previously reported for American Indian and Alaska Native individuals, according to a study published online March 9 in JAMA Ophthalmology.

Stephanie J. Fonda, Ph.D., from Estenda Solutions Inc. in Wayne, Pennsylvania, and colleagues examined incidence and progression of DR in 8,374 American Indian and Alaska Native individuals using data from the Indian Health Service teleophthalmology program for diabetic eye disease (2015 through 2019).

The researchers found that of patients with no DR in 2015, 18.0 percent had mild nonproliferative DR (NPDR) or worse in 2016 to 2019 and 0.1 percent (10 of 7,097) had proliferative DR. The incidence rate of progression from no DR to any DR was 69.6 cases per 1,000 person-years at risk. Progression from no DR to moderate NPDR or worse occurred among 6.2 percent of participants (i.e., 2+ step increase; 24.0 cases per 1,000 person-years at risk).

Of patients with mild NPDR in 2015, 27.2 percent progressed to moderate NPDR or worse in 2016 to 2019 and 2.3 percent progressed to severe NPDR or worse. There was an association observed between incidence and progression and expected risk factors and evaluation with ultra-widefield imaging.

“The results suggest extending the time between DR reevaluations for certain patients in this population, if follow-up compliance and visual acuity outcomes are not jeopardized,” the authors write.

More information:
Stephanie J. Fonda et al, Incidence and Progression of Diabetic Retinopathy in American Indian and Alaska Native Individuals Served by the Indian Health Service, 2015-2019, JAMA Ophthalmology (2023). DOI: 10.1001/jamaophthalmol.2023.0167

Aleksandra Rachitskaya, Use of Teleophthalmology to Evaluate the Incidence and Progression of Diabetic Retinopathy, JAMA Ophthalmology (2023). DOI: 10.1001/jamaophthalmol.2023.0321

Journal information:
JAMA Ophthalmology

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