Clinical Ophthalmology (Sep 2020)
Self-Reported Awareness of Retinopathy Severity in Diabetic Patients
Abstract
Yaqoob Qaseem,1 Sahej Samra,1 Olga German,1 Elizabeth Gray,2 Manjot K Gill1 1Department of Ophthalmology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA; 2Biostatistics Collaboration Center, Feinberg School of Medicine, Northwestern University, Chicago, IL, USACorrespondence: Manjot K GillDepartment of Ophthalmology, Feinberg School of Medicine, Northwestern University, Suite 440, 645 N Michigan Avenue, Chicago, IL 60611, USATel +1 312-908-8152Email [email protected]: 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
