The degree to which retinopathy occurs in Africans with abnormal glucose tolerance is unknown. Therefore, the objective of this study was to screen for diabetic retinopathy in self-identified healthy African immigrants. A total of 167 Africans now living in the Washington DC area underwent a medical workup and eye exam at the NIH. Visual acuity, intraocular pressure, slit lamp biomicroscopy and dilated fundus biomicroscopy were performed. Diagnostic testing included color fundus photography, fundus autofluorescence, and optical coherence tomography of the macula and optic nerve. The participants were 41 ± 10 years old (mean ±SD) and duration of stay in the U.S.A was 12 ± 10y. BMI was 28 ± 4 kg/m2, and 17 (10%) participants were being treated for hypertension. OGTT revealed diabetes in 15 (9%) participants, and prediabetes in 58 (35%) participants. Retinopathy was detected in 7 (4.2%) participants, 5 of whom had findings consistent with mild non-proliferative diabetic retinopathy in the setting of diabetes (n=3) or prediabetes (n=2) on OGTT. One participant had a flame shaped hemorrhage due to untreated Stage 2 hypertension, and one participant without vascular risk factors had peripheral dot-blot hemorrhages. Participants with retinopathy were older (49 ± 10 vs. 40 ± 10 years old, p=0.02), had higher systolic BP (140 ± 25 vs. 119 ± 14 mmHg, p<0.001) and higher A1C (6.4 ± 2.2% vs. 5.4 ± 0.6%, p<0.001) than participants without retinopathy. There was no difference in retinopathy rates based on sex, African region, BMI, education level, income, drinking/smoking status, physical activity, or sickle cell/HbC trait status. In short, OGTT testing reveals that African immigrants who self-identify as healthy have high rates of undetected diabetes and prediabetes. Some (4.2%) already have retinopathy, and require annual follow-up to monitor for progression. Vascular risk factors including hypertension and prediabetes were associated with retinopathy, and we would recommend screening at-risk individuals.


P.G. Christakis: None. J. Kabakambira: None. S.M. Briker: None. C. DuBose: None. A.E. Sumner: None. E. Chew: None.

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