African Americans (AAs) are one of the largest minority populations in the United States. In 2011, 43.2 million persons in the US (14.1%) were of African ancestry. AAs exhibit a different pattern of eye disease than other racial/ethnic groups and are largely under-represented in studies of eye disease. Specifically, AAs are believed to have higher rates of visual impairment, blindness, open angle glaucoma (OAG), diabetic retinopathy (DR) but lower rates of age-related macular degeneration (AMD) than Non-Hispanic Whites (NHW) (1-5). However, most of the data that inform our estimates of the burden of eye disease in AAs are from two population based assessments initiated and conducted 20-28 years ago in Maryland (The Baltimore Eye Survey [1985-88] and The Salisbury Eye Evaluation Project [1993-95] (1, 6)). Since the completion of these two population-based studies, results of numerous clinical trials have reported the benefits of tighter glycemic control on the development of DR, and lower intraocular pressure on the development and progression of glaucoma. Findings from these two population based studies (showing the higher risk of vision loss, OAG and DR in AAs) have been incorporated into screening programs and clinical practice. Finally, with the aging of the U.S. population, the burden of age-related eye disease is likely to increase among AAs who are disproportionately impacted by obesity and diabetes. Given the implementation of numerous screening programs on AAs, the aging of the AA population, important changes in clinical practice, and the lack of recent population-based prevalence estimates, updated estimates of the burden of eye disease in AAs are needed. Characterization of the prevalence, the biological mechanisms (i.e., the risk relationships) of these diseases, and their impact on activities of daily life needs to be completed to allow for planning of preventive measures, and targeted screening and treatment programs. Further, it is crucial to determine the underlying reasons AAs may receive less follow-up eye care. Finally, while current data exists on the incidence of eye disease in NHW and Latinos, this study creates a cohort for obtaining the first incidence data on eye disease in AAs.
The African American Eye Disease Study (AFEDS) is designed to fill the gaps in our current understanding, while building on the knowledge and experience gained from three population- based epidemiologic studies of ocular diseases in the Los Angeles area: the Multiethnic Pediatric Eye Disease Study (MEPEDS), the Los Angeles Latino Eye Study (LALES), and the Chinese American Eye Study (CHES). This project therefore presents a unique opportunity to measure robust estimates of the prevalence of visual impairment, blindness, OAG and DR in AAs and evaluate how these eye diseases impact quality of life.