Defining the Epidemiology and Risk of Diabetic Retinopathy among Aboriginal Australians: A Longitudinal Cohort Study

Abstract: Worldwide trends show that diabetic retinopathy (DR), an eye complication of diabetes, is still a common cause of blindness. Over two decades (1990-2010) in low-to-middle income regions the prevalence of blindness because of DR has gone up 64%, but in high-income regions like Australia it has remained stable. However, for Indigenous Australians the story is inconsistent with the trends seen in high-income regions, in that the rate of DR has essentially doubled over a similar time period (20.9% in 1996 to 39.4% in 2017). Additionally, because the advanced severities of DR are higher and experienced earlier in life among Indigenous Australians, the rates of blindness are 5 times that of other Australians. To date, the research effort achieved in relation to DR for Indigenous Australians has concentrated on eye outcomes in solidarity, lack comprehensive investigations into the broader determinants shaping these DR outcomes, and early markers of disease are unknown. This PhD presentation will outline the research framework, which utilises a large (n=~1300) biomedical cohort of Indigenous Australians with baseline and forthcoming four-year follow-up medical, biological and eye data to better understand the natural history and underlying psychosocial, clinical, biological and genetic risk factors. The program will uniquely enhance our understanding of DR through; 1) exploring the clinical characteristics of individuals with DR 2) investigating the relevant risk factors for DR 3) identifying novel indicators that can predict who is at heightened risk of blindness and 4) developing a care model for managing diabetic eye complications. Ultimately, in the hope to reduce the human/societal cost of blindness among Indigenous Australians.