Abstract
Abstract: :
Purpose:It is estimated that half of all diabetics do not undergo the recommended annual eye examination. Unfortunately, many of these patients eventually present to an ophthalmologist with visual changes from proliferatve diabetic retinopathy. The goal of this study was to determine the frequency of inadequate screening and characteristics of patients treated with panretinal photocoagulation (PRP) for proliferative diabetic eye disease. Methods:Records of 128 consecutive patients who underwent PRP at Los Angeles County Hospital were reviewed. Patients with known Type I or Type II Diabetes Mellitus of any duration were included. The interval between the visit referring patient for PRP and previous dilated fundus examination was noted. Other data collected included age, sex, race, indication for PRP and visual acuity. Results:Seven patients were excluded from the study. One was newly diagnosed with diabetes based on her eye examination, 1 patient had CRVO and no diabetes and 5 had insufficient records to determine interval since last examination. All patients had high–risk PDR, severe PDR (as defined by the ETDRS) and/or rubeosis. 100 (83%) patients had exams within the previous year, 1 (0.8%) patient had an exam between 1 and 2 years and 20 (16.5%) had no exams for 2 years or more. One patient with an 8–year history of diabetes had never had an eye examination. Age, sex, race, indication for PRP and proportion of patients with severe visual loss (visual acuity less than 5/200) were similar between the groups (p>0.2). Conclusions:This study shows that a significant proportion of patients requiring panretinal photocoagulation for proliferative diabetic eye disease in our community have had screening eye examinations less frequently than recommended. Identifying barriers to timely patient examinations and developing novel approaches to overcome these barriers are necessary.
Keywords: diabetic retinopathy • clinical (human) or epidemiologic studies: health care delivery/economics/manpower