PREDICTORS OF LATE PRESENTATION OF DIABETIC RETINOPATHY: A MISSED OPPORTUNITY FOR HEALTH SYSTEMS IN

Abstract

Diabetic retinopathy is one of the most common complications of diabetes which can lead to visual impairment or even blindness. However, early detection and prompt treatment can reduce the risk of visual impairment significantly. Therefore, it is important to detect the socioeconomic predictors of late presentation of diabetic retinopathy which was the objective of this study. Methods A cross sectional study was conducted in Retina department of Al- Shifa Trust Eye Hospital for duration of four months. All patients diagnosed with diabetic retinopathy for the first time were inducted and data was collected through an interview-based questionnaire. Classification into stages was done based on system developed by American Academy of Ophthalmology. Multivariable logistic regression was conducted to identify predictors of late presentation of diabetic retinopathy. Results Out of total sample (n= 243), 170 (70%) presented with vision threatening diabetic retinopathy. Final multivariate analysis demonstrated that patient registration category, and area of residence were the two statistically significant predictors of late presentation (VTDR) of disease. Patients who were registered in free (non-paying) category of the hospital had a 21.9 times higher risk of presenting with VTDR as compared to privately (fully paying) registered patients. Conclusion Socioeconomic variables were found to be statistically significant predictors of late presentation of diabetic retinopathy. Therefore, targeted services should be provided to the socioeconomically deprived people