April 2014
Volume 55, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2014
Is socioeconomic deprivation associated with prevalence of diabetic retinopathy in a free access national screening programme?
Author Affiliations & Notes
  • Liying Low
    Ophthalmology, University of Birmingham, Birmingham, United Kingdom
    Ophthalmology, University of Dundee, Dundee, United Kingdom
  • Simon Ogston
    Ophthalmology, University of Dundee, Dundee, United Kingdom
  • Peter Wilson
    Ophthalmology, University of Dundee, Dundee, United Kingdom
  • Carrie MacEwen
    Ophthalmology, University of Dundee, Dundee, United Kingdom
  • Footnotes
    Commercial Relationships Liying Low, None; Simon Ogston, None; Peter Wilson, None; Carrie MacEwen, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science April 2014, Vol.55, 5348. doi:
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      Liying Low, Simon Ogston, Peter Wilson, Carrie MacEwen; Is socioeconomic deprivation associated with prevalence of diabetic retinopathy in a free access national screening programme?. Invest. Ophthalmol. Vis. Sci. 2014;55(13):5348.

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Abstract

Purpose: To explore the association between socioeconomic deprivation and prevalence of diabetic retinopathy (DR) in type 1 and 2 Diabetes Mellitus (DM) patients in East of Scotland where free annual DR screening programme is provided to all patients with DM above the age of 12 years.

Methods: We collected data on diabetic retinopathy screening (digital retinal photography) from Scottish regional diabetes electronic record between January 2011 & December 2012. Using the residential postcode, we obtained the overall Scottish Index of Multiple Deprivation 2012 (SIMD) score for each patient. We used multiple logistic regression to analyse the relationship between overall SIMD score and prevalence of DR, adjusting for other variables: age, gender, HbA1c, cholesterol levels & duration of diabetes.

Results: In patients with type 1 DM (n=1861), 88.2% attended their annual DR screening. Increased prevalence of DR in type 1 DM was independently associated with higher overall SIMD score(OR 1.01, 95% CI 1.00-1.02, p=0.008), male gender (OR 1.32, p=0.015), higher HbA1c value(OR 1.35, p<0.001), higher cholesterol levels (OR 1.174, p=0.03), younger age(OR 1.17, p=0.03), and longer duration of disease (OR 3.17, p<0.001). In contrast, 93.5% of type 2 DM patients (n=18197) attended their annual DR screening. The overall SIMD score was not independently associated with the prevalence of DR(OR 0.998, 95% CI 0.995-1.000, p=0.074). Prevalence of DR was strongly associated with longer duration of diabetes(OR 1.99, p<0.001), higher HbA1c value(OR 1.22, p<0.001), higher cholesterol levels(OR 1.07, p=0.001) and male gender(OR 1.19, p<0.001).

Conclusions: Socioeconomic deprivation is independently associated with increased prevalence of diabetic retinopathy in type 1 DM patients, but not for type 2 DM patients. This finding highlights the need for targeted interventions to address inequalities in eye healthcare.

Keywords: 460 clinical (human) or epidemiologic studies: health care delivery/economics/manpower • 499 diabetic retinopathy • 463 clinical (human) or epidemiologic studies: prevalence/incidence  
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