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Social inequities sadly still persist within the fields of ophthalmology and research. We have a treatment for diabetic macular edema, which is the most common cause of blindness in individuals suffering from diabetes. However, that treatment does not cure all people equally. Bevacizumab (commonly known as Avastin), is the most common treatment in the United States for diabetic macular edema. However, in a study done by the American Academy of Ophthalmology, it was discovered that Black patients are significantly less likely than their white counterparts to show visual improvement after being injected with the drug.
Image: Avastin, the current treatment for diabetic macular edema, is significantly less effective for Black patients, highlighting inequities in ophthalmological research.
In this study, which was the first one to look at race as a factor for the treatment of diabetic macular edema, researchers looked at data from the electronic medical records of patients that were treated at the Boston Medical Centre. After receiving one injection of Avastin, only 26.71% of Black patients experienced improved vision, compared to 50% of White patients. After receiving 3 injections, 33.82% of Black patients experienced improved vision compared to 58.54% of White patients. This is extremely alarming, as diabetic eye diseases, as well as diabetes itself already affect Black patients disproportionately, yet they do not benefit as much from the current treatment than Caucasian patients. According to the U.S Department of Health and Human Services, African American adults are 60% more likely to have been diagnosed with diabetes than white adults.
The prevalence of diabetic macular edema and diabetes in Black adults can be attributed to a variety of factors, including socioeconomic status, which affects one’s access to health care, especially in countries like the United States where healthcare is not free. However, there is no excuse for the lack of effectiveness of Avastin on Black patients. This highlights the need for increased diversity in clinical trials, so that we can ensure that treatments work effectively on all patients.
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