Diabetic eye disease and screening attendance by ethnicity in New Zealand: A systematic review

Clin Exp Ophthalmol. 2019 Sep;47(7):937-947. doi: 10.1111/ceo.13528. Epub 2019 May 20.


To examine differences in incidence, prevalence and screening for diabetic retinopathy in New Zealand, we searched MEDLINE, EMBASE and CINAHL up to 6 December 2018 for observational studies reporting diabetic eye disease or attendance at retinal screening, disaggregated by ethnicity. Two authors separately screened and selected studies, and extracted data. None of the 11 included studies reported data on visual impairment from diabetic retinopathy. All nine studies reporting diabetic eye disease by ethnicity found Pacific people and Māori had higher rates of sight-threatening disease and lower rates of screening attendance compared to Europeans. Data for Asian people were infrequently reported, but when they were, they also fared worse than Europeans. This review highlights that equity-focused strategies are needed to address ethnic disparities in eye health among New Zealanders with diabetes. The review also identifies how research methods can be strengthened to enable future calculation of robust disease prevalence estimates.

Keywords: Māori health; New Zealand; Pacific peoples health; diabetes eye care; diabetic maculopathy; diabetic retinopathy; diabetic retinopathy screening attendance; ethnic disparity; health equity.

Publication types

  • Comparative Study
  • Systematic Review

MeSH terms

  • Diabetic Retinopathy / diagnosis*
  • Diabetic Retinopathy / ethnology*
  • Health Services Accessibility / statistics & numerical data*
  • Healthcare Disparities / statistics & numerical data*
  • Humans
  • Native Hawaiian or Other Pacific Islander / ethnology
  • New Zealand / epidemiology
  • Vision Screening / trends*
  • Whites / ethnology