Disparities Between Teleretinal Imaging Findings and Patient-Reported Diabetic Retinopathy Status and Follow-up Eye Care Interval: A 10-Year Prospective Study
Authors' conclusion
Substantial discrepancies exist between DR presence, patient awareness, and concordance of follow-up across all DR severity levels. These discrepancies are present across all eye care provider types, with the magnitude influenced by provider type. Therefore, patient self-report should not be relied upon to reflect DR status. Modification of medical care and education models may be necessary to enhance retention of ophthalmic knowledge in patients with diabetes and ensure accurate communication between all health care providers.
Study context
- Population
- Consecutive patients with diabetes who underwent retinal imaging during an endocrinology visit25,360 analysed
- Participants
- 26,876 patients
- Exposure
- Self-reported diabetic retinopathy (DR) awareness and follow-up vs concurrent retinal imaging findings
- No DRn = 14,317
- Mild DRn = 6,805
- Vision-threatening DR (vtDR)n = 4,238
- Outcome
- Self-reported awareness of DR and concordance of eye examination follow-up compared with concurrent retinal imaging findings
Methodological details10-year, consecutive patients
- 10-year
- Consecutive patients
Main finding
As reported in the abstract
Observational data: associations, not effects.
Further findings
Factors associated with reporting no prior DR when DR present
- Associated with shorter DM duration, milder DR, last eye examination >1 year before, no dilation, no scheduled appointment, less specialized provider
- all P < 0.001
vtDR: not aware of any DR, by prior examining provider
- Retinal specialist
- 41.2%
- Nonretinal ophthalmologist
- 58.1%
- Optometrist
- 64.2%
vtDR: follow-up concordant with current DR severity, by prior examining provider
- Retinal specialist
- 66.7%
- Nonretinal ophthalmologist
- 41.3%
- Optometrist
- 25.4%
- Difference across providers
- P < 0.001
Original publication
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