In Shanxi Eye Hospital, approximately one-third of diabetes patients who come to the retinal eye clinic are in an advanced stage of diabetic retinopathy (DR), a diabetes complication. They are said to have advanced proliferative DR. In nearly all cases, the vision of patients with advanced proliferative DR could not be restored, even after they had received complex vitreo-retinal surgery.
The aim of this study was to explore the socioeconomic characteristics of patients presenting with advanced proliferative DR and who hadn't yet received laser treatment for proliferative DR. It also explored the barriers to eye care. It is hoped that this study will be a first step in addressing prevention of blindness from advanced proliferative DR in this region.
One hundred and fifty-eight consecutive diabetes patients were recruited from the retinal outpatient clinic of the hospital: all were attending for the first time and had never received laser treatment before. The patients' socioeconomic status was recorded and ophthalmic examinations were performed. Patients presenting with advanced proliferative DR were also invited to either in-depth interviews or focus group discussions to determine barriers to eye care.
Of the 158 patients recruited for this study, 24.7% presented with advanced proliferative DR. Late presentation was significantly associated with education, occupation, health insurance, family size, and presenting complaints. However, the only variable independently associated with late presentation was education. The main reasons were lack of awareness and not having been referred to eye specialists by their physicians.
It is recommended that physicians in Shanxi province be informed about the risks of DR in patients with diabetes. In addition, a hospital-based screening programme among diabetes patients will serve to both identify early-stage DR and educate patients about this complication.