DR Incidence in American Indians and Alaskan Natives Similar to Rest of US Population

Findings revealed that approximately 21% of American Native/Alaskan Native patients with diabetes have DR. Despite the variation in rates of diabetes between this group and other population cohorts, this study did not find a significant difference in their rates of DR in the meta-analysis. Photo: Julie Torbit, OD. Click image to enlarge. The burden of diabetic retinopathy (DR) care in the US is projected to increase due to the growing prevalence of diabetes mellitus and its associated vascular risk factors, as well as the increased lifespan of patients with diabetes due to population aging and lifestyle changes. Evaluating and estimating the prevalence and severity of DR nationwide is necessary to guide resource distribution for surveillance, timely management and prevention of severe vision loss. It is undetermined whether the increased risk of diabetes also confers an increased risk of DR for Indigenous Americans. Also, there have been no prior American meta-analyses pooling the prevalence and severity of DR across the country.To address these gaps, a recent study, published in Ophthalmology, aimed to estimate the national prevalence of DR, proliferative DR (PDR), diabetic macular edema (DME) and vision-threatening DR among both American Indian/Alaskan Native patients and other American patients who are not in these population groups. As the largest meta-analysis to date, comprising more than 10 million individuals, it determined that there appears to be no appreciable difference in the prevalence of DR between the American Indian/Alaskan Native populations and patients outside of this cohort. However, the researchers noted that the evidence was limited by the heterogeneity of the assessed studies.However, the researchers acknowledged that the heterogeneity of the assessed studies limited the certainty of the evidence they found.They also noted that underreporting of DR in these specific populations may also confound their results, as these patients would be less likely to enroll in screening programs.Overall, the researchers included 53 studies of 10,070,617 individuals in their analysis. The study estimated DR, PDR, DME and vision-threatening DR prevalence to be 21%, 3%, 3% and 3% for American Indian/Alaskan Native populations and 20%, 2%, 3% and 5% for populations outside this cohort, respectively. It did not find a significant difference in rates of DR between these groups of patients in the meta-analysis.“Studying specific prevalence of DR in specific populations allows us to focus public health and clinical efforts on underdiagnosed populations as well as underserved communities at the margins,” the researchers wrote in their paper.The team highlighted that improved access to screening of DR for all patients, in particular for historically disadvantaged groups, will allow for appropriate surveillance and early intervention to reduce complications of DR and vision loss.“To improve diagnosis in Indigenous patients who may reside in more remote regions, telehealth is a cost-effective and convenient alternative method to conventional retinal examination to improve adherence to recommended screening,” the study authors suggested.Broad effective screening estimates may aid in public health strategies and resource allocation to reduce preventable vision loss. Click here for the journal source. Yu Cw, Nanji K, Garg A, et al. The prevalence of diabetic retinopathy in American Indians/Alaska Natives and non-Indigenous Americans: a systematic review and meta-analysis. Ophthalmology. August 13, 2025. [Epub ahead of print].This article was developed by the editorial staff in conjunction with experts in the field. In the process, AI may have been among the editorial tools used to meet the goals of human editors, who approved all content.