Objective:
To provide national prevalence estimates of diabetic retinopathy (DR) and its complications in American Indians/Alaska Natives (AI/AN) compared to nonindigenous Americans.
Key Findings:
- 21% of AI/AN patients with diabetes had any DR, compared to 20% of non-AI/AN patients.
- 3% of AI/AN patients had PDR, while 2% of non-AI/AN patients had PDR.
- DME prevalence was 3% in both groups.
- VTDR was reported in 3% of AI/AN patients and 5% of non-AI/AN patients.
- Longer diabetes duration and HbA1c ≥8% correlated with higher DR prevalence.
Interpretation:
The prevalence of DR among AI/AN patients is comparable to non-AI/AN patients, but the evidence is of very low certainty due to study limitations.
Limitations:
- Substantial heterogeneity among studies.
- Potential underreporting in AI/AN groups due to access barriers.
- Lack of age-standardized or diabetes type-specific prevalence data.
- Few direct comparisons between AI/AN and non-AI/AN populations.
Conclusion:
Improving screening and treatment in underserved populations is essential, with recommendations for teleophthalmology and AI-based diagnostics.
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