Diabetic Retinopathy and Eye Screening: Diabetic Patients Standpoint, Their Practice, and Barriers; A Cross-Sectional Study

Alali, Naif Mamdouh; Albazei, Alanuad I; Alotaibi, Horia Mohammed; Almohammadi, Ahad Massd; Alsirhani, Eilaf Khaled; Alanazi, Turki Saleh; Alshammri, Badriah Jariad; Alqahtani, Mohammed Qasem; Magliyah, Moustafa; Alreshidi, Shaker; ALBalawi, Hani B

doi:10.3390/jcm11216351

Cited by 7 publications

(4 citation statements)

References 28 publications

(33 reference statements)

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“…Other referrals were provided for visually significant cataract (n = 1684, 51.14%), age-related macular degeneration (n = 256, 7.77%), glaucoma (n = 68, 2.06%), and other reasons (n = 20, 0.61%). Re-screening guidelines of the Early Treatment Diabetic Retinopathy Study classification were used to advise follow-up to all other patients [9,[10][11][12].…”

Section: Resultsmentioning

confidence: 99%

Eight years’ experience in mobile teleophthalmology for diabetic retinopathy screening

Appukumran¹,

Shyamsundar²,

Agrawal³

et al. 2023

Med Hypothesis Discov Innov Ophthalmol

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Background: Screening for diabetic retinopathy in the community without compromising the routine workof ophthalmologists at hospitals is the essence of teleophthalmology. This study was aimed at investigating theefficacy of teleophthalmology practice for screening diabetic retinopathy from 2012 to 2020. It was also aimed at comparing the 2-year prevalence of camps organized by a district hospital in South India, as well as the footfall, reporting, follow-up, patient response, and diagnostic efficacy at these camps. Methods: All patients with diabetes and unexplained vision deterioration attending the mobile camp unitsunderwent non-dilated fundus photography. Patients underwent teleconsultation with the ophthalmologist atthe district hospital, and those requiring intervention were called to the district hospital. Trends were studiedfor the number of patients reporting to the hospital. Patient satisfaction was recorded based on a questionnaire. Results: A total of 682 camps were held over 8 years, and 30 230 patients were examined. Teleconsultationwas done for 12 157 (40.21%) patients. Patients requiring further investigations, intervention for diabeticretinopathy, or further management of other ocular pathologies were urgently referred to the district hospital(n= 3293 [10.89%] of 30 230 examined patients). The severity and presence of clinically significant macularedema increased significantly with an increased duration of diabetes mellitus (P < 0.001). The percentage ofteleconsultations showed an increasing trend over the years (P = 0.001). Similarly, considering trends of patientsreporting to the hospital, the attrition rate decreased over the years (P < 0.05). A total of 10 974 of 12 157(90.27%) patients who underwent teleophthalmic consultation were satisfied with the service. Conclusions: Teleconsultations over the years showed an increasing trend, and the attrition rate decreased overthe years. Teleophthalmology is achieving success in providing high-quality service, easy access to care, and inincreasing patient satisfaction. Future studies on the role of teleophthalmology for other leading preventablecauses of blindness seem possible and necessary.

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Section: Resultsmentioning

confidence: 99%

Eight years’ experience in mobile teleophthalmology for diabetic retinopathy screening

Appukumran¹,

Shyamsundar²,

Agrawal³

et al. 2023

Med Hypothesis Discov Innov Ophthalmol

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“…An alarming 75.1% of T2DM patients expressed unawareness of the recommended frequency of eye checks. In contrast, a study conducted in Saudi Arabia revealed that 73.3% of diabetic patients were aware of the need for regular eye check-ups ( 35 ). The significant knowledge gap observed in our study regarding screening for DR may be attributed to a lack of understanding about the importance of eye screening.…”

Section: Discussionmentioning

confidence: 97%

Undiagnosed diabetic retinopathy in Northeast China: prevalence and determinants

Zang,

Rong,

et al. 2023

Front. Endocrinol.

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ObjectiveTo report the prevalence and contributing factors of undiagnosed diabetic retinopathy (DR) in a population from Northeastern China.Subjects/MethodsA total of 800 subjects from the Fushun Diabetic Retinopathy Cohort Study were enrolled. A questionnaire assessing incentives and barriers to diagnosis of DR was administered. Logistic regression was used to identify clinical and sociodemographic factors associated with undiagnosed DR. In a prespecified subgroup analysis, we divided patients into vision-threatening diabetic retinopathy (VTDR) and non-VTDR (NVTDR) subgroups.ResultsAmong 800 participants with DR, 712 (89.0%) were undiagnosed. Among 601 with NVTDR, 566 (94.2%) were undiagnosed. Among 199 with VTDR, 146 (73.4%) were undiagnosed. The risk factors affecting the timely diagnosis of NVTDR and VTDR exhibit significant disparities. In multivariate models, factors associated with undiagnosed VTDR were age over 60 years (OR = 2.966; 95% CI = 1.205-7.299; P = 0.018), duration of diabetes over 10 years (OR = 0.299; 95% CI = 0.118-0753; P = 0.010), visual impairment or blindness (OR = 0.310; 95% CI = 0.117-0.820; P = 0.018), receiving a reminder to schedule an eye examination (OR = 0.380; 95% CI = 0.163-0.883; P = 0.025), and the belief that “people with diabetes are unlikely to develop an eye disease” (OR = 4.691; 95% CI = 1.116-19.724; P = 0.035). However, none of the factors were associated with undiagnosed NVTDR (all P ≥ 0.145).ConclusionOur research has uncovered a disconcerting trend of underdiagnosis in cases of DR within our population. Addressing determinants of undiagnosed DR may facilitate early detection.

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“…DR is a retinal complication of prolonged DM that affects the retinal microvasculature [ 32 ]. As a result, the longer the duration of DM, the higher the risk of developing DR or sight-threatening DR is usually considered.…”

Section: Discussionmentioning

confidence: 99%

Recommendations for initial diabetic retinopathy screening of diabetic patients using large language model-based artificial intelligence in real-life case scenarios

Gopalakrishnan,

Joshi,

Chhablani

et al. 2024

Int J Retin Vitr

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Purpose To study the role of artificial intelligence (AI) to identify key risk factors for diabetic retinopathy (DR) screening and develop recommendations based on clinician and large language model (LLM) based AI platform opinions for newly detected diabetes mellitus (DM) cases. Methods Five clinicians and three AI applications were given 20 AI-generated hypothetical case scenarios to assess DR screening timing. We calculated inter-rater agreements between clinicians, AI-platforms, and the “majority clinician response” (defined as the maximum number of identical responses provided by the clinicians) and “majority AI-platform” (defined as the maximum number of identical responses among the 3 distinct AI). Scoring was used to identify risk factors of different severity. Three, two, and one points were given to risk factors requiring screening immediately, within a year, and within five years, respectively. After calculating a cumulative screening score, categories were assigned. Results Clinicians, AI platforms, and the “majority clinician response” and “majority AI response” had fair inter-rater reliability (k value: 0.21–0.40). Uncontrolled DM and systemic co-morbidities required immediate screening, while family history of DM and a co-existing pregnancy required screening within a year. The absence of these risk factors required screening within 5 years of DM diagnosis. Screening scores in this study were between 0 and 10. Cases with screening scores of 0–2 needed screening within 5 years, 3–5 within 1 year, and 6–12 immediately. Conclusion Based on the findings of this study, AI could play a critical role in DR screening of newly diagnosed DM patients by developing a novel DR screening score. Future studies would be required to validate the DR screening score before it could be used as a reference in real-life clinical situations. Clinical trial registration Not applicable.

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Diabetic Retinopathy and Eye Screening: Diabetic Patients Standpoint, Their Practice, and Barriers; A Cross-Sectional Study

Cited by 7 publications

References 28 publications

Eight years’ experience in mobile teleophthalmology for diabetic retinopathy screening

Eight years’ experience in mobile teleophthalmology for diabetic retinopathy screening

Undiagnosed diabetic retinopathy in Northeast China: prevalence and determinants

Recommendations for initial diabetic retinopathy screening of diabetic patients using large language model-based artificial intelligence in real-life case scenarios

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