Undiagnosed Diabetic Retinopathy : Burden and Clinico Demographic Profile

Worldwide, above 50% of Diabetic retinopathy (DR) remains undiagnosed. As the number of people living with diabetes (PLWD) in India is high and increasing, the magnitude of undiagnosed DR is likely to be high.

This study was performed to identify the burden of undiagnosed DR and compare the clinical and demographic profile of diabetic patients with previously diagnosed and undiagnosed retinopathy.

In this cross-sectional comparative hospital-based study from South India, patients with type 2 Diabetes mellitus were screened for DR and divided into 2 groups — previously diagnosed and previously undiagnosed. Clinico-demographic profile and perceptions regarding barriers for DR screening were noted and analyzed.

Of the 450 participants, DR was observed in 192 (42.66%) with 86 (19.12%) previously diagnosed DR and 106 (23.55%) undiagnosed DR. Those with undiagnosed DR were more likely to be on combined treatment of oral hypoglycaemics and insulin (p = 0.00), less compliant with treatment (p = 0.00), more likely to have family history of diabetes (p = 0.01) and complications like foot ulcer (p = 0.04). Vision threatening DR was significantly higher (p = 0.04) among undiagnosed DR patients. Lack of awareness was the most commonly cited barrier for DR screening (190, 42.2%).

The high frequency of undiagnosed, vision-threatening DR and lack of awareness emphasizes the urgent need for patient education.