Diabetes is one of the most serious health problems that the African American community faces today since, compared to the general population, African Americans are disproportionately affected by diabetes and 13.2% of all African Americans aged 20 years or older have diagnosed diabetes and African Americans are 1.7 times more likely to have diabetes compared to non-Hispanic whites. Diabetes is associated with an increased risk for a number of serious microvascular complications like diabetic eye disease-retinopathy, nephropathy, neuropathy and African Americans experience an even greater threat. Several studies have found that African Americans have a higher risk of developing diabetic retinopathy and vision loss from diabetic eye disease compared with Caucasians even while controlling for the known risk factors. Limited studies exist that investigate the factors that make African Americans more vulnerable to diabetic retinopathy.

Optical coherence tomography angiography (OCTA) is a recently developed, noninvasive, dye-less imaging modality, which can visualize moving blood within retinal vessels and The University of Chicago is one of the few centers nationally and internationally using this new technology for clinical care of our patients with retinal diseases and diabetes in the diverse south side of Chicago.

Clinical studies of retinal vasculature have long relied on fluorescein angiography to provide important details about the retinal microvasculature. Fluorescein angiography can only visualize the large superficial retinal vessels and is invasive with intravenous dye injection and time consuming. The major advantage of OCTA is its ability to resolve the vascular layers of the retina in three dimensions and distinguish for the first time in vivo, fast and non-invasively the different retinal capillary plexuses: the superficial, deep capillary plexus and choriocapillaris in the macula.

Some studies suggest that early changes seen in the retinal capillary plexuses could correlate with risk of diabetic retinopathy severity and vision loss but these studies include mostly Caucasians or do not differentiate between ethnicities. Even though there are some data indicating that the retinal tissue in African Americans is significantly thinner compared to Caucasians, no data are available regarding retinal microvasculature and retinal capillaries characteristics between African Americans and Caucasians that could predispose African Americans to diabetic retinopathy and vision loss from diabetes. We propose a study investigating the retinal vascular capillaries by optical coherence tomography angiography in African Americans and compare the findings to Caucasians.

We aim to investigate if the characteristics of retinal vascular capillaries evaluated non-invasively by optical coherence tomography angiography in African Americans as are different compared to Caucasians as an etiology for increased vulnerability to retinal vascular diseases, diabetic retinopathy, and blindness from diabetes.

The results of this study may contribute new insight to the factors that make African Americans more prone to diabetic retinopathy, blindness compared to other ethnicities and may stimulate biomedical studies that could elucidate the pathogenesis of development of diabetic retinopathy and other microvascular complications like diabetic nephropathy in African American community leading to earlier detection and prevention. The University of Chicago is situated in a racially, ethnically, and socioeconomically diverse community with large portion of our patients being African Americans. This study could provide some light into the biological mystery of predisposition of African Americans to microvascular retinal and other complications and blindness and promote our mission for patient-centered care and reducing health disparities.

Optical Coherence Tomography Angiography will be performed in non-diabetic African American adults and will be compared to age and sex matched non-diabetic Caucasian adults. The evaluation of the retinal capillaries plexuses will include a combination of numerical characteristics such as capillary density, presence of avascular areas and surface area of blood flow or absent blood flow. These parameters in all the subjects will be automatically calculated by the AngioAnalytics software that has been given with special permission to The University of Chicago, J. Terry Ernest Ocular Imaging Center as one of the few research centers in the world with access to the automated software for vessel parameters calculations. We will also apply computerized texture analysis on the choriocapillaris images in collaboration with Dr Patrick Lariviere from the department of Physics/Radiology to look into pattern and texture differences in the deep choriocapillaris vascular layer between the 2 ethnical groups.

STATA

Weekly Ophthalmology Grand Rounds and Didactics, Ophthalmology clinics, Research meetings with mentor every week.