Vision-threatening retinopathy in diabetics not referred to an ophthalmologist

Background: Vision-threatening forms of diabetic retinopathy (macular edema and proliferative retinopathy) can be efficiently treated with laser. Any delay in access to ophthalmic care may limit the opportunity of treatment. Diabetics that are not referred to an ophthalmologist are a vulnerable population, which could lose vision as a result of delayed attention. Material and methods: Observational, descriptive, prospective, cross-sectional study in diabetics attending a hospital for non-ophthalmological causes, without prior evaluation of the ocular fundus. The proportion of eyes with vision-threatening diabetic retinopathy, and that of eyes in which visual loss could be prevented were identified. Results: 100 patients, mean age 55.5 years, 53 females; 48 had diabetic retinopathy, six had proliferative retinopathy (6%; 95% CI: 1.3-10.7), and 23 had macular edema (23%; 95% CI: 14.8-31.2); the proportion of diabetic macular edema was higher than the one reported in the same population 15 years before (odds ratio 4.01; 95% CI: 1.98-8.15). Fifty-six percent of the patients with vision-threatening retinopathy did not have visual deficiency. Conclusion: Detection and referral of diabetic patients with risk of visual loss must be made easier, regardless of their visual symptoms, in order to achieve treatment efficacy by timely care.