Diabetic Eye Screening: Knowledge and Perspectives from Providers and Patients

Abstract

Purpose of review: Diabetic retinopathy remains the leading cause of blindness among working-age U.S. adults even though timely screening and treatment prevent 90% of blindness. We summarize current knowledge and perspectives to better understand why diabetic eye screening rates remain low and future directions towards preventing blindness from diabetes. Recent findings: Significant advancements in the past 10 years include primary care and patient-oriented interventions as well as the use of teleophthalmology. In England, diabetic eye disease is no longer the leading cause of certifiable blindness following the implementation of a national teleophthalmology program for diabetic retinopathy. Summary: Multiple workflow and systems-level barriers affect providers. Patient barriers include a limited understanding of screening and lack of access to care. Interventions have been developed, but new barriers exist towards sustaining their impact. More research is needed to identify and implement the best practices to increase diabetic eye screening rates long-term.

The effect of educational program based on theory of planned behavior on promoting retinopathy preventive behaviors in patients with type 2 diabetes: RCT

“…Raising awareness as well as other constructs of Theory of Planned Behavior, including attitudes, behavioral intention, and perceived behavioral control, all led to increased skills and preventive behaviors by patients with diabetes. Liu and colleagues also suggest that eye care behaviors can prevent blindness by up to 90% [29]. In the Mumba study, the number of ophthalmological examinations increased from 29 to 47% by training patients at a Tanzanian referral hospital [30], but Dan et al did not observe an increase in patients performance by providing 10-min educational multimedia [19].…”

Factors influencing patient adherence with diabetic eye screening in rural communities: A qualitative study

“…Furthermore, innovative technological strategies such as teleophthalmology may complement patient education in improving patient adherence by directly addressing environmental barriers to diabetic eye screening in rural populations such as less access and greater travel distances to obtain eye care [ 6 – 8 , 41 – 43 ]. Similar barriers are present in rural communities within low and medium income countries where specialists are concentrated in urban areas [ 44 – 46 ].…”

Quantitative proteomics analysis of vitreous body from type 2 diabetic patients with proliferative diabetic retinopathy

“…Classification of NPDR is based on clinical findings manifested by visible features, including microaneurysms, retinal hemorrhages, intraretinal microvascular abnormalities (IRMA), and venous caliber changes, while PDR is characterized by the hallmark feature of pathologic preretinal neovascularization [ 2 ]. With the increasing global prevalence of diabetes, DR is the major cause of vision loss and blindness among working-age adults in developed countries [ 3 ]. Current treatments for diabetic eye disease, which include laser photocoagulation, intravitreous injections of anti-VEGF and steroid agents and vitreoretinal surgery, mainly focus on advanced diseases such as PDR [ 4 ].…”