J Korean Ophthalmol Soc.  2016 Jul;57(7):1080-1086. 10.3341/jkos.2016.57.7.1080.

Main Reasons for and Associated Factors of the First Fundus Examination in Diabetic Patients

• Park SJ
• Seo HJ
• Lee DY
• Nam DH

• KMID: 2317568
• DOI: http://doi.org/10.3341/jkos.2016.57.7.1080

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.

Keyword

Diabetes; Diabetic retinopathy; Education on diabetes; First fundus examination

MeSH Terms

Diabetic Retinopathy
Diagnosis
Education
Female
Humans
Male
Ophthalmology
Patient Education as Topic
Prevalence
Tertiary Care Centers

Reference

References

1. Kahn HA, Hiller R. Blindness caused by diabetic retinopathy. Am J Ophthalmol. 1974; 78:58–67.

2. Klein R, Klein BE, Moss SE, Linton KL. The Beaver Dam Eye Study. Retinopathy in adults with newly discovered and previously diagnosed diabetes mellitus. Ophthalmology. 1992; 99:58–60.

3. Stolk RP, Vingerling JR, de Jong PT, et al. Retinopathy, glucose, and insulin in an elderly population. The Rotterdam study. abdominal. 1995; 44:11–5.

4. Mitchell P, Smith W, Wang JJ, Attebo K. Prevalence of diabetic abdominal in an older community. The Blue Mountains Eye Study. Ophthalmology. 1998; 105:406–11.

5. Mitchell P, Moffitt P. Update and implications from the Newcastle diabetic retinopathy study. Aust N Z J Ophthalmol. 1990; 18:13–7.

6. Narendran V, John RK, Raghuram A, et al. Diabetic retinopathy among self reported diabetics in southern India: a population based assessment. Br J Ophthalmol. 2002; 86:1014–8.

7. Nagi DK, Pettitt DJ, Bennett PH, et al. Diabetic retinopathy abdominal by fundus photography in Pima Indians with impaired abdominal tolerance and NIDDM. Diabet Med. 1997; 14:449–56.

8. Klein R, Klein BE, Moss SE. The Wisconsin epidemiological study of diabetic retinopathy: a review. Diabetes Metab Rev. 1989; 5:559–70.

9. Gregg EW, Cheng YJ, Saydah S, et al. Trends in death rates among U.S. adults with and without diabetes between 1997 and 2006: findings from the National Health Interview Survey. Diabetes Care. 2012; 35:1252–7.

10. Edwards AL. Funduscopic examination of patients with diabetes who are admitted to hospital. CMAJ. 1968; 134:1263–5.

11. American Diabetes Association. Standards of medical care in dia-betes–2014. Diabetes Care. 2014; 37(Suppl 1):S14–80.

12. Kim HK, Oh TS, Lee SM, Lee JB. The initial fundus examination and severity of diabetic retinopathy at a primary eye clinic. J Korean Ophthalmol Soc. 2005; 46:982–8.

13. Kim JS, Chin HS, Moon YS. A clinical analysis and referral rate on diabetic retinopathy in diabetic patients referred for eye examination at a tertiary hospital. J Korean Ophthalmol Soc. 2003; 44:1093–101.

14. Park MY, Ohn YH, Shin HH. Clinical analysis diabetic retinopathy for diabetics who were consulted from medical department. J Korean Ophthalmol Soc. 1994; 35:1068–72.

15. Chang K, Chung IH, Lee JH. Clinical analysis of diabetic abdominal. J Korean Ophthalmol Soc. 1981; 22:707–14.

16. Lim SJ, Kwon OW, Kim HB. Clinical analysis of diabetic abdominal according to the type of diabetes mellitus. J Korean Ophthalmol Soc. 1986; 27:1045–51.

17. Shim SD, Kim SY. The initial fundus examination and severity of diabetic retinopathy in diabetic patients diagnosed over 30 years of age. J Korean Ophthalmol Soc. 1999; 40:2198–204.

18. Klein R, Klein BE, Moss SE, et al. The Wisconsin epidemiologic study of diabetic retinopathy. III. Prevalence and risk of diabetic retinopathy when age at diagnosis is 30 or more years. Arch Ophthalmol. 1984; 102:527–32.