PURPOSE: To describe the prevalence and risk factors of diabetic retinopathy in a multi-ethnic US population of whites,blacks,hispanics,and chinese. DESIGN: Cross-sectional study of 778 individuals from ages 45 to 85 years with diabetes,participating in the Multi-Ethnic Study of Atherosclerosis (MESA). METHODS: Retinal photographs were obtained with a 45° nonmydriatic digital fundus camera. Presence and severity of diabetic retinopathy were graded at a central reading center on the basis of a modification of the Airlie House classification system. All participants underwent a standardized interview,examination,and laboratory investigations. RESULTS: In this population with diabetes,the prevalence of any retinopathy was 33.2% and macular edema 9.0% . The prevalence of any diabetic retinopathy and macular edema was significantly higher in blacks (36.7% and 11.1% ) and hispanics (37.4% and 10.7% ) than in whites (24.8% and 2.7% ) and chinese (25.7% and 8.9% ) (P=.01 and P=.007,comparing racial/ethnic differences for retinopathy and macular edema,respectively). Significant independent predictors of any retinopathy were longer duration of diabetes,higher fasting serum glucose,use of diabetic oral medication or insulin,and greater waist-hip ratio. Race was not an independent predictor of any retinopathy. CONCLUSIONS: This study provides contemporary data on the prevalence of and risk factors for diabetic retinopathy among whites,blacks,hispanics,and chinese participating in the MESA.
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