SEARCHCROSS-SECTIONALophthalmology, retina

cross-sectional·ophthalmology, retina, endocrinology, epidemiology, public health·PMC10903851

Investigation of the reasons for delayed presentation in proliferative diabetic retinopathy patients

PLOS ONE · 10 authors, 5 centres

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TL;DR

This cross-sectional questionnaire study investigated reasons for delayed presentation in 157 consecutive patients with proliferative diabetic retinopathy (PDR).

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This cross-sectional questionnaire study investigated reasons for delayed presentation in 157 consecutive patients with proliferative diabetic retinopathy (PDR). The mean age was 50.0 years, and the median HbA1c was 7.8%. Logistic analysis identified factors related to refusing DR treatment: inability to receive regular diabetes treatment (OR 6.78), intolerance to discomfort during examination/treatment (OR 15.15), and not being informed of the need for regular screening after a normal exam (OR 2.05). Limitations include the cross-sectional design, exclusion of well-controlled DM patients, low use of anti-VEGF agents, and lack of visual acuity and some systemic measures. The findings highlight the need for improved DM screening, patient education, and follow-up care by both internal medicine and ophthalmology practitioners.

STUDY TYPE

cross-sectional

SPECIALTY

ophthalmology

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100% · A

ORIGINAL PAPER

PMC10903851

Investigation of the reasons for delayed presentation in proliferative diabetic retinopathy patients

PLOS ONE

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ABSTRACT

Abstract Aim To investigate reasons for delayed presentation in patients with proliferative diabetic retinopathy (PDR). Methods A questionnaire was designed to investigate consecutive PDR patients with delayed presentation who visited our center between January 2021 and December 2021. The questionnaire was divided into four sections: knowledge regarding diabetic retinopathy (DR), attitude toward DR treatment, difficulties adhering to follow-up plans, and medical care. The systemic disease status and severity of DR were recorded. Logistic analysis was undertaken to investigate DR treatment refusal and delay factors. Results A total of 157 patients were included in this study, with an average age of 50.0 ± 11.6 years. The median glycated hemoglobin level (HbA1c) was 7.8% (IQR 2.5%). Among the 157 eyes, most required vitrectomy intervention (144, 91.7%); 17 developed neovascular glaucoma (NVG), while only 13 required additional photocoagulation. Among the 36 patients with undiagnosed DM, the reason for delayed DR presentation was a lack of awareness of DM status among these patients (36 cases, 100.0%). Most of the patients with a known history of DM exhibited inadequate DR knowledge (29, 24.0%), believed their good visual acuity did not require DR screening (98, 81.0%), and had poorly controlled diabetes (113, 93.3%). Factors related to refusing DR treatment were patients with an inability to receive regular diabetes treatment in internal medicine clinics (OR 6.78, 95% CI 1.73–26.59, p = 0.006), patients who could not tolerate discomfort during ophthalmic examination and treatment (OR 15.15, 95% CI 2.70–83.33, p<0.001), and patients who did not have any retinal abnormalities detected and were not informed about the need for regular screening (OR 2.05, 95% CI 1.36–3.09, p<0.001). Conclusions This study investigated the factors contributing to delayed presentation among patients with PDR. Many individuals in the delayed population were found to have undiagnosed DM. Among patients already aware of their DM status, reasons for delay included insufficient knowledge about DR, negative attitudes toward screening and treatment, and difficulties seeking medical care in real-life situations. Furthermore, there needed to be more improvements in the detection, treatment, and follow-up of DR by internal medicine practitioners and ophthalmologists.

CITATION EXPORT

Meng Zhao, Aman Chandra, Lin Liu et al.. Investigation of the reasons for delayed presentation in proliferative diabetic retinopathy patients. PLOS ONE. (2024). https://doi.org/10.1371/journal.pone.0291280

AUTHORS

10 · 5 CENTRES

Meng Zhao, Aman Chandra, Lin Liu, Lin Zhang, Jun Xu, Jipeng Li, Jiro Kogo, Jiro Kogo, Jiro Kogo, Jiro Kogo

1Ophthalmology, Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing Tongren Hospiospital, Dongcheng District, Beijing, 100730, China
2Mid & South Essex NHS Foundation Trust (Southend University Hospital) Prittlewell Chase Essex SS00RY, Southend-on-Sea, United Kingdom
3Anglia Ruskin University, Cambridge, United Kingdom
4Endocrinology, Beijing Tongren Hospital, Capital Medical University, Dongcheng District, Beijing, 100730, China
5St. Marianna University School of Medicine, JAPAN