There is increasing evidence from population-based studies that isolated signs of retinopathy, such as microaneurysms and retinal hemorrhages, are common in people without diabetes. However, the risk factors associated with retinopathy in nondiabetic persons remain uncertain, and there are few data describing retinopathy in nonwhite populations, especially Chinese or Hispanic.
Using data from the Multi-Ethnic Study of Atherosclerosis, researchers evaluated the prevalence of retinopathy and associations with cardiovascular risk factors in persons without diabetes in a large, multi-ethnic population.
The prevalence of retinopathy was 12.5 percent overall, which is higher than that found in other population-based studies. The authors write that this higher prevalence can be partly explained by methodological differences, as well as differences in population characteristics such as ethnicity.
Chinese subjects had the highest prevalence (17.2 percent), followed by blacks (13.9 percent), Hispanics (12.6 percent) and whites (11.9 percent). Hypertension was strongly associated with retinopathy, but this association was strongest in blacks. The authors did not attempt to explain this strong association in blacks, but said it was concerning. After adjusting for age, gender, race, and other parameters, smoking and increased internal carotid intima media thickness were also associated with retinopathy.
The authors conclude that the high prevalence of retinopathy in all ethnic groups, but especially in Chinese participants, is concerning given previous findings associating retinopathy with risk of cerebrovascular disease and mortality. Further examination of the associated risk factors leading to such a high prevalence, particularly in Chinese subjects, is warranted.