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Clinical features of diabetic patients referred by general physicians due to less ophthalmic examinations

Authors Otsu Y, Matsuoka M, Matsuyama K, Nishimura T

Received 7 April 2014

Accepted for publication 19 May 2014

Published 16 July 2014 Volume 2014:8 Pages 1331—1335

DOI https://doi.org/10.2147/OPTH.S65707

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 3


Yayoi Otsu, Masato Matsuoka, Kayako Matsuyama, Tetsuya Nishimura

Department of Ophthalmology, Kansai Medical University, Takii Hospital, Osaka, Japan

Background: The purpose of this study was to determine the clinical features of patients with type 2 diabetes, and less ophthalmic examinations, referred by general physicians to ophthalmologists.
Methods: The medical charts of 327 patients with type 2 diabetes referred to our department from general physicians were reviewed. A detailed medical history was taken and a complete ophthalmic examination was performed for all patients. The patients were divided into two groups, ie, those with a history of missing ophthalmic examinations for more than a year (noncompliant group) and those with no previous ophthalmic examinations (never-examined group). Serum levels of glycosylated hemoglobin and creatinine, estimated glomerular filtration rate, and urine albumin/creatinine ratio were obtained from medical records.
Results: Of the 327 patients, 102 had diabetic retinopathy (31.2%), with a mean best-corrected visual acuity of 0.037±0.36 logMAR (logarithm of the minimum angle of resolution) units. Of the 327 patients, 203 were in the never-examined group and 124 were in the noncompliant group. The incidence of diabetic retinopathy in the noncompliant group was significantly higher than that in the never-examined group (P<0.001). Best-corrected visual acuity in the noncompliant group was significantly worse than in the never-examined group (P=0.004). Glycosylated hemoglobin levels and estimated glomerular filtration rate in the noncompliant group were significantly lower than in the never-examined group (P<0.001 and P<0.003, respectively); serum creatinine levels and urine albumin/creatinine ratio were significantly higher (P=0.020 and P=0.001, respectively). The severity of the diabetic retinopathy was significantly correlated with compliance in terms of ophthalmic examinations and with urine albumin/creatinine ratio (multiple regression analysis, P=0.047 and P<0.001, respectively).
Conclusion: Our results show that diabetic patients referred from general physicians due to less ophthalmic examinations generally have good visual acuity, but one third of them have diabetic retinopathy. A history of missing ophthalmic examinations and albuminuria are risk factors for diabetic retinopathy.

Keywords: diabetic retinopathy, general physician, ophthalmologists, albuminuria

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