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Abstract
Purpose
To determine the major reasons that diabetics decide to undergo their first fundus examination, and the factors influencing such reasons.
Methods
Of the patients with type II diabetes who presented to the Department of Ophthalmology in Gachon University Gil Medical Center, 164 patients who underwent their first fundus examination after being diagnosed with diabetes were included in the study. Face-to-face and phone interviews with these patients were conducted.
Results
The average prevalence period from the diagnosis of diabetes to the first fundus examination was 8.3 ± 7.5 years. Of the diabetics who underwent their first fundus examination, 52.4% had diabetic retinopathy, with no significant difference in prevalence between the male and female patients (p = 0.118). The most common reason for deciding to undergo the first fundus examination was recommendation by a doctor (53.7%). For those patients who received their first fundus examination after recommendation by a doctor, the prevalence period from diabetes was the shortest among all patients (p < 0.001), and the prevalence and severity of diabetic retinopathy were the lowest (p < 0.001 and p = 0.017, respectively). The number of fundus examinations conducted following recommendation by a doctor was significantly higher in secondary and tertiary hospitals than in primary hospitals (p < 0.001). Education on diabetes and knowledge of diabetic ocular complications were found to be significantly correlated (p < 0.001).
Conclusions
For patients who are diagnosed with diabetes and treated in primary hospitals, who are older, or who did not receive education on diabetes, recommendation by a doctor for early fundus examination is particularly important regardless of subjective visual disturbance. Moreover, patient education should be offered and ophthalmic examination should be recommended in primary hospitals.
References
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Table 1.
Patient's sex, age, duration of diabetes and prevalence of diabetic retinopathy
| No. | Age (years) | Duration of DM (years) | Prevalence of DR (%) | |
|---|---|---|---|---|
| Total | 164 | 55.6 ± 11.8 | 8.3 ± 7.5 | 86/164 (52.4) |
| Male | 82 | 54.3 ± 10.6 | 7.7 ± 7.9 | 48/82 (58.5) |
| Female | 82 | 56.9 ± 11.0 | 8.8 ± 7.1 | 38/82 (46.3) |
| p-value | 0.087* | 0.247* | 0.118† |
Table 2.
Severity of diabetic retinopathy and type of hospital according to main reasons for initial fundus examination
| Main reason for initial fundus examination | No. | Age (years) | Duration of DM (years) | Prevalence of DR |
Severity of DR |
Type of hospital |
||
|---|---|---|---|---|---|---|---|---|
| NPDR | PDR | Primary | Secondary or Tertiary | |||||
| Total | 164 (100.0%) | 108 (100.0%) | 56 (100.0%) | |||||
| Subjective visual | 35 (21.3%) | 60.6 ± 10.8 | 14.2 ± 8.1 | 28/35 (80.0%) | 11/35 | 17/35 (48.6%) | 32 (29.6%) | 3 (5.4%) |
| disturbance | (31.4%) | |||||||
| Doctor's | 88 (53.7%) | 54.6 ± 8.9 | 5.7 ± 6.2 | 33/88 (37.5%) | 27/88 | 6/88 (6.8%) | 40 (37.0%) | 48 (85.7%) |
| recommendation | (30.7%) | |||||||
| Family's | 11 (6.7%) | 60.7 ± 9.8 | 13.3 ± 6.0 | 10/11 (90.9%) | 6/11 | 4/11 (36.4%) | 10 (9.3%) | 1 (1.8%) |
| recommendation | (54.5%) | |||||||
| DM education | 23 (14.0%) | 48.9 ± 10.2 | 6.3 ± 7.1 | 10/23 (43.5%) | 5/23 | 5/23 (21.7%) | 19 (17.6%) | 4 (7.1%) |
| (21.7%) | ||||||||
| Mass media | 7 (4.3%) | 56.9 ± 11.4 | 10.7 ± 7.5 | 5/7 (71.4%) | 3/7 | 2/7 (28.6%) | 7 (6.5%) | 0 (0.0%) |
| (42.9%) | ||||||||
| p-value | 0.327† | <0.001† | <0.001* | 0.017* | <0.001* | |||
Table 3.
Severity of diabetic retinopathy and presence of diabetes education
|
Hospital |
p-value | ||
|---|---|---|---|
| Primary | Secondary or tertiary | ||
| Prevalence of DM | 75/108 (69.4%) | 11/56 (19.6%) | <0.001* |
| Duration of DM (years) | 9.4 ± 8.9 | 6.3 ± 5.6 | <0.001† |
| Severity of DR | 0.027* | ||
| NPDR | 42 (38.9%) | 10 (17.9%) | |
| PDR | 33 (30.6%) | 1 (1.8%) | |
| DM education | <0.001* | ||
| Yes | 34 (31.5%) | 47 (83.9%) | |
| No | 74 (68.5%) | 9 (16.1%) | |
Table 4.
Knowledge of diabetic ocular complications
|
Known ocular complication |
||
|---|---|---|
| Unknown | Known | |
| DM education (n,%) | ||
| No | 64 (77.1) | 19 (22.9) |
| Yes | 9 (11.1) | 72 (88.9) |
| p-value* | <0.001 | |
Table 5.
Prevalence and severity of diabetic retinopathy according to subjective visual disturbance
| Prevalence of DR |
Severity of DR |
||
|---|---|---|---|
| NPDR | PDR | ||
| Subjective visual disturbance | |||
| No | 56/112 (50.0%) | 37 (33.0%) | 19 (17.0%) |
| Yes | 30/52 (57.7%) | 15 (28.8%) | 15 (28.8%) |
| p-value* | 0.359 | 0.146 | |
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