Back to Journals » Clinical Ophthalmology » Volume 14

Self-Reported Awareness of Retinopathy Severity in Diabetic Patients

Authors Qaseem Y, Samra S, German O, Gray E, Gill MK

Received 23 June 2020

Accepted for publication 18 August 2020

Published 25 September 2020 Volume 2020:14 Pages 2855—2863


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Dr Scott Fraser

Yaqoob Qaseem, 1 Sahej Samra, 1 Olga German, 1 Elizabeth Gray, 2 Manjot K Gill 1

1Department of Ophthalmology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA; 2Biostatistics Collaboration Center, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA

Correspondence: Manjot K Gill
Department of Ophthalmology, Feinberg School of Medicine, Northwestern University, Suite 440, 645 N Michigan Avenue, Chicago, IL 60611, USA
Tel +1 312-908-8152

Background: Diabetic retinopathy (DR) may be asymptomatic in both mild and advanced stages. A patient’s accurate perception of their DR severity may therefore be critical for effective self-management behaviors and understanding the need for timely intervention and follow-up.
Purpose: To evaluate the relationship between self-reported and actual retinopathy severity in diabetic patients.
Methods: This study was a single-center cross-sectional survey. Diabetic patients identified by enterprise data warehouse were sent an online questionnaire where they were asked to self-assess for presence of DR and grade their severity. Actual DR grading was determined via chart review. The primary outcome measures were patient-assessed DR severity and agreement with actual DR severity.
Results: Of 3208 invitations sent, 324 (10%) patients responded and 319 responses were analyzed. The data showed that 39 of 253 (15%) with no DR, 26 of 40 (65%) with mild/moderate DR, and 24 of 26 (92%) with severe DR believed they had DR (p< 0.001). Of those with no DR, 214 of 253 (85%) accurately assessed absence of DR. Of those with mild/moderate DR, 25 of 40 (63%) accurately assessed their severity, 14 of 40 (35%) believed they had no DR, and 1 of 40 (3%) believed they had severe DR. In patients with severe DR, 9 of 26 (35%) correctly assessed their severity, 15 of 26 (58%) believed they had mild/moderate DR, and 2 of 26 (8%) believed they had no DR.
Conclusion: Patients with severe DR were the most likely to report presence of DR, but often underestimated their disease severity. Many with mild/moderate DR did not realize they had DR. This consistent underestimation of severity across all a significant barrier to timely follow-up and treatment necessary to prevent future visual impairment.

Keywords: diabetic retinopathy, diabetes, survey, severity, perception, awareness, understanding, anti-VEGF, barriers, screening, accuracy, self-report

Erratum for this paper has been published

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]