Abstract
Abstract: :
Purpose: Diabetic retinopathy is a leading cause of blindness in the world, predicted to reach epidemic proportions in developed countries. We intend to identify the common socioeconomic risk factors for first presentation of sight threatening diabetic retinopathy, in order to find those groups most at risk. Methods:This is a hospital based pilot case control study. Fifty two patients were newly diagnosed with diabetic retinopathy having their visual acuity checked and a complete eye examination. Twenty four patients with visual acuity < 6/12 were considered to be cases (late presenters) having sight threatening status (non proliferative retinopathy with maculopathy or proliferative with vitreous haemorrhage or/with neovascularization or with tractional retinal detachment). Twenty eight controls had early non proliferative diabetic retinopathy (VA >6/12). Patients with possible diagnosis of diabetic retinopathy and other severe eye diseases with diabetic retinopathy were excluded. A questionnaire regarding age, sex, ethnic origin, economic status, education and employment was completed by each qualifying patient. Results:There was no difference in the median ages of the cases (62.4 yrs) and controls (60.8). Cases were significantly less likely to be male (cases 50%, control 70%; p=0.007). In terms of ethnic origin, comparing whites versus others the results showed that cases were significantly more likely to be from ethnic minority groups (cases 80%, controls 50%;p=0.020). There was no difference in the type of housing (cases 54%, control 53.5%; p=0.4). Controls were more likely to have access to a car (cases 46%, controls 68%; p=0.03). In terms of educational qualifications 42% of cases had no formal qualifications compared with 29% of controls. In terms of skills, cases were 50% unskilled, compared with 25% in the control group. Conclusions:Results of this pilot study indicate that there is a correlation between the socioeconomic status of a patient and the late presentation of diabetic retinopathy. A larger sample size will allow confirmation of these results. It is quite likely that extreme cases may never participate for screening for various reasons, which indicates a need for different approaches to educate and inform deprived social groups or even compensate them for income lost through hospital attendance. The study can support a case for additional resources to be applied in this area.
Keywords: diabetic retinopathy • clinical (human) or epidemiologic studies: risk factor assessment • diabetes