Incidence of diabetic retinopathy in indigenous Australians within Central Australia: the Central Australian Ocular Health Study

Landers, John; Henderson, Tim; Abhary, Sotoodeh; Craig, Jamie E

doi:10.1111/j.1442-9071.2011.02725.x

Cited by 6 publications

(9 citation statements)

References 17 publications

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“…Because the real-world cohort was restricted to patients already exhibiting DR, the expected time from diagnosis of DM to onset of mild non-proliferative retinopathy was determined from local administrative data, showing a 7.7% annual incidence. This is in line with estimates from the literature, with various reports showing incidence rates of 8.0%–8.4% in recent Australian populations [16], 3.9%–7.1% in a population of Medicaid patients from the 1990s [17]. The second is for transition from proliferative retinopathy (state 3) to vision loss (state 4)for which rates were taken to be 0.7%, annualized from published incidences [18].…”

Section: Methodssupporting

confidence: 83%

An Agent-Based Modeling Template for a Cohort of Veterans with Diabetic Retinopathy

et al. 2013

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BackgroundAgent-based models are valuable for examining systems where large numbers of discrete individuals interact with each other, or with some environment. Diabetic Veterans seeking eye care at a Veterans Administration hospital represent one such cohort.ObjectiveThe objective of this study was to develop an agent-based template to be used as a model for a patient with diabetic retinopathy (DR). This template may be replicated arbitrarily many times in order to generate a large cohort which is representative of a real-world population, upon which in-silico experimentation may be conducted.MethodsAgent-based template development was performed in java-based computer simulation suite AnyLogic Professional 6.6. The model was informed by medical data abstracted from 535 patient records representing a retrospective cohort of current patients of the VA St. Louis Healthcare System Eye clinic. Logistic regression was performed to determine the predictors associated with advancing stages of DR. Predicted probabilities obtained from logistic regression were used to generate the stage of DR in the simulated cohort.ResultsThe simulated cohort of DR patients exhibited no significant deviation from the test population of real-world patients in proportion of stage of DR, duration of diabetes mellitus (DM), or the other abstracted predictors. Simulated patients after 10 years were significantly more likely to exhibit proliferative DR (P<0.001).ConclusionsAgent-based modeling is an emerging platform, capable of simulating large cohorts of individuals based on manageable data abstraction efforts. The modeling method described may be useful in simulating many different conditions where course of disease is described in categorical stages.

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Section: Methodssupporting

confidence: 83%

An Agent-Based Modeling Template for a Cohort of Veterans with Diabetic Retinopathy

et al. 2013

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“…Furthermore, only 33% of Indigenous DR cases identified to benefit from laser photocoagulation from the SAEHP actually underwent treatment . A meta‐analysis of international studies conducted from 1975 to 2008 in patients not yet treated for DR showed that rates of progression to PDR and severe vision loss are substantially lower since 1985 compared with the pre‐1985 era . Differences are partly explained by more severe levels of DR at baseline and poorer glycaemic control prior to 1985.…”

Section: Discussionmentioning

confidence: 99%

“…7,8,21 A meta-analysis of international studies conducted from 1975 to 2008 in patients not yet treated for DR showed that rates of progression to PDR and severe vision loss are substantially lower since 1985 compared with the pre-1985 era. 6,16,31 Differences are partly explained by more severe levels of DR at baseline and poorer glycaemic control prior to 1985. A more rapid progression to VTDR for Indigenous Australians for the same underlying reasons may explain the equal rates of VTDR between Indigenous and non-Indigenous Australians with DM, despite lower rates of any DR seen in Indigenous Australians from the current analysis.…”

Section: Discussionmentioning

confidence: 99%

Review of the prevalence of diabetic retinopathy in Indigenous Australians

Kaidonis

Mills

Landers

et al. 2014

Clinical Exper Ophthalmology

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The purpose of this review was to compare the prevalence of diabetic retinopathy (DR) between Indigenous and non-Indigenous Australians with Diabetes Mellitus (DM) using all available reported data, in order to help direct further research to those most susceptible to severe outcomes. All published studies describing prevalence of DR in a defined study population within Australia published between 1985 and 2013 were identified. Potentially relevant studies were reviewed and the following published data was extracted: study design, sample size with self-reported DM, indigenous status, mean age and range, gender, mean duration of DM, prevalence and severity of DR, and method used to grade DR. Six Indigenous studies (2865 persons with DM) and 5 non-Indigenous studies (9801 persons with DM) reporting DR prevalence satisfied inclusion criteria. Estimated prevalence of any DR among Indigenous Australians with DM was 23.4% compared with 28.9% for non-Indigenous Australians (χ 2

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“…Even though numerous risk factors have been described in the literature influencing the rapid and unprecedented rise in T2DM prevalence rates in Indigenous populations around the globe [26], fragmented and insufficient data are available on the factors contributing to many of the downstream complications such as retinopathy [6]. For example, large population-based studies to date have only provided evidence for the epidemiology of DR alongside investigations into a narrow range of risk factors, which have identified geography (remote, OR 2.46), diabetes duration (OR 1.69), and a glycosylated haemoglobin percentage (HbA1c) above 7% as being associated with having DR among Indigenous Australians [15,27]. These studies have not investigated the complex T2DM/DR phenotype and the underlying social, psychological, environmental, behavioural, clinical, biological, metabolomic and genetic risk factors.…”

Section: Addressing the Knowledge Gapsmentioning

confidence: 99%

“…The risk factors of interest to sight-threatening DR may be fundamentally psychosocial, environmental, clinical, biological or genetic in nature, but are best interpreted together given the complexity of the T2DM phenotype and its vascular complications [18,28]. Non-modifiable and modifiable risk factors such as living remotely, duration of diabetes, increasing age, access to health care and poor glycaemic control are likely to also play an important role in the development of sight-threatening DR [15,27]. However, health inequities based on gender and socioeconomic standing can further influence the wellbeing of an individual, with reports suggesting that socioeconomic factors alone could explain more than two-thirds of the global variation in prevalence of vision impairment and blindness [29].…”

Section: Addressing the Knowledge Gapsmentioning

confidence: 99%

Working Towards Eye Health Equity for Indigenous Australians with Diabetes

Estevez

Howard

Craig

et al. 2019

IJERPH

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Type 2 diabetes mellitus (T2DM) poses significant challenges to individuals and broader society, much of which is borne by disadvantaged and marginalised population groups including Indigenous people. The increasing prevalence of T2DM among Indigenous people has meant that rates of diabetes-related complications such as blindness from end-stage diabetic retinopathy (DR) continue to be important health concerns. Australia, a high-income and resource-rich country, continues to struggle to adequately respond to the health needs of its Indigenous people living with T2DM. Trends among Indigenous Australians highlight that the prevalence of DR has almost doubled over two decades, and the prevalence of diabetes-related vision impairment is consistently reported to be higher among Indigenous Australians (5.2%-26.5%) compared to non-Indigenous Australians (1.7%). While Australia has collated reliable estimates of the eye health burden owing to T2DM in its Indigenous population, there is fragmentation of existing data and limited knowledge on the underlying risk factors. Taking a systems approach that investigates the social, environmental, clinical, biological and genetic risk factors, and-importantly-integrates these data, may give valuable insights into the most important determinants contributing to the development of diabetes-related blindness. This knowledge is a crucial initial step to reducing the human and societal impacts of blindness on Indigenous Australians, other priority populations and society at large.

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Incidence of diabetic retinopathy in indigenous Australians within Central Australia: the Central Australian Ocular Health Study

Abstract: Background: To estimate the incidence of diabetic retinopathy (DR) within the indigenous Australian population living in Central Australia.

Cited by 6 publications

References 17 publications

An Agent-Based Modeling Template for a Cohort of Veterans with Diabetic Retinopathy

An Agent-Based Modeling Template for a Cohort of Veterans with Diabetic Retinopathy

Review of the prevalence of diabetic retinopathy in Indigenous Australians

Working Towards Eye Health Equity for Indigenous Australians with Diabetes

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