Abstract
Purpose :
Diabetic retinopathy (DR) is a leading cause of blindness among adults. Timely diagnosis and treatment can significantly reduce the risk of vision loss. To prevent long-term complications, the American Academy of Ophthalmology recommends an initial eye exam soon after diabetes diagnosis and routine exams thereafter. However, studies reveal inadequate adherence to these guidelines, particularly among minorities. This study aims to assess the disparities in utilization of eye care services among patients with type 2 diabetes followed at an academic eye center.
Methods :
In this retrospective study, we evaluated medical records of patients with type 2 diabetes who were seen in the eye clinic from 2004 to 2023 (n = 809) and were followed for at least three years. We only included patients for whom primary care visit data and the date of the first diabetes diagnosis were available. We assessed the timing of dilated fundus examination, and the prevalence of diabetic retinopathy (DR) and vision-threatening DR (defined by the presence of severe non-proliferative DR, proliferative DR, or diabetic macular edema).
Results :
We included a total of 136 patients who met the inclusion criteria (60.3% female). Mean age at the first eye exam was 66.68 years (SD ±14.41). The ethnic composition was diverse, comprising non-Hispanic Whites (46.3%), African Americans (17.6%), Latinos (16.2%), Asians (12.5%), and other groups, with bilingual individuals comprising 15.4% of the population. Medicare was the primary health insurance for 48.5% of the patients, followed by private health insurance (47.1%) and Medi-Cal(1.5%). The average time from diabetes diagnosis to the initial eye exam was 10.37±10.50 years, and the majority of patients (77.9%) did not exhibit signs of DR at the first exam. Only 8.08% of patients underwent an eye exam within 1 year after diagnosis of diabetes. Over the follow-up period, 10.3% of the patients developed vision-threatening DR, with the highest rates among Latinos (27.3%) followed by Whites (26.2%).
Conclusions :
Most patients in the present series did not undergo an eye exam within one year after diabetes diagnosis. The observed high prevalence of vision-threatening complications, particularly among racial minorities, emphasizes the need for targeted interventions and improved access to timely eye screenings to mitigate potential complications in at-risk populations.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.