Neil M Bressler1, Rohit Varma2, Quan V Doan3, Michelle Gleeson3, Mark Danese3, Julie K Bower4, Elizabeth Selvin4, Chantal Dolan5, Jennifer Fine5, Shoshana Colman5, Adam Turpcu5. 1. Wilmer Eye Institute, Johns Hopkins University School of Medicine and Hospital, Baltimore, Maryland. 2. Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, University of Illinois College of Medicine, Chicago. 3. Outcomes Insights, Inc, Westlake Village, California. 4. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland. 5. Genentech, Inc, South San Francisco, California.
Abstract
IMPORTANCE: Thickening of the center of the retina, diabetic macular edema (DME), is the most common cause of visual loss due to diabetes mellitus. Treatment of DME has improved dramatically, and the prompt diagnosis of DME and referral of these patients have become more critical. Nonetheless, awareness of and care for DME in the US population is uncharacterized. OBJECTIVE: To characterize eye care and awareness of eye disease among persons with DME in the general US population. DESIGN, SETTING, AND PARTICIPANTS: Cross-sectional analysis of data from participants in the 2005 to 2008 National Health and Nutrition Examination Survey 40 years or older with diabetes mellitus and fundus photographs. MAIN OUTCOMES AND MEASURES: Among persons with DME, (1) awareness that diabetes has affected their eyes; (2) report on the last time they visited a diabetes specialist; (3) report on their last eye examination with pupil dilation; and (4) prevalence of visual impairment. RESULTS: In 2010, only 44.7% (95% CI, 27.0%-62.4%) of US adults 40 years or older with DME reported being told by a physician that diabetes had affected their eyes or that they had retinopathy; 46.7% (95% CI, 27.5%-66.0%), that they had visited a diabetes nurse educator, dietician, or nutritionist for their diabetes mellitus more than 1 year ago or never; and 59.7% (95% CI, 43.5%-75.9%), that they had received an eye examination with pupil dilation in the last year. Among persons with DME, 28.7% (95% CI, 12.7%-44.7%) were visually impaired (defined as visual acuity worse than 20/40 in the eye with DME) based on visual acuity at the initial examination and 16.0% (95% CI, 2.5%-29.4%) based on best-corrected visual acuity. CONCLUSIONS AND RELEVANCE: Many persons with diabetes mellitus in the United States are not getting care that can prevent visual impairment and blindness. Strategies to increase awareness are warranted, especially given the recent availability of improved therapies for DME.
IMPORTANCE: Thickening of the center of the retina, diabetic macular edema (DME), is the most common cause of visual loss due to diabetes mellitus. Treatment of DME has improved dramatically, and the prompt diagnosis of DME and referral of these patients have become more critical. Nonetheless, awareness of and care for DME in the US population is uncharacterized. OBJECTIVE: To characterize eye care and awareness of eye disease among persons with DME in the general US population. DESIGN, SETTING, AND PARTICIPANTS: Cross-sectional analysis of data from participants in the 2005 to 2008 National Health and Nutrition Examination Survey 40 years or older with diabetes mellitus and fundus photographs. MAIN OUTCOMES AND MEASURES: Among persons with DME, (1) awareness that diabetes has affected their eyes; (2) report on the last time they visited a diabetes specialist; (3) report on their last eye examination with pupil dilation; and (4) prevalence of visual impairment. RESULTS: In 2010, only 44.7% (95% CI, 27.0%-62.4%) of US adults 40 years or older with DME reported being told by a physician that diabetes had affected their eyes or that they had retinopathy; 46.7% (95% CI, 27.5%-66.0%), that they had visited a diabetes nurse educator, dietician, or nutritionist for their diabetes mellitus more than 1 year ago or never; and 59.7% (95% CI, 43.5%-75.9%), that they had received an eye examination with pupil dilation in the last year. Among persons with DME, 28.7% (95% CI, 12.7%-44.7%) were visually impaired (defined as visual acuity worse than 20/40 in the eye with DME) based on visual acuity at the initial examination and 16.0% (95% CI, 2.5%-29.4%) based on best-corrected visual acuity. CONCLUSIONS AND RELEVANCE: Many persons with diabetes mellitus in the United States are not getting care that can prevent visual impairment and blindness. Strategies to increase awareness are warranted, especially given the recent availability of improved therapies for DME.
Authors: Diana V Do; Quan Dong Nguyen; David Boyer; Ursula Schmidt-Erfurth; David M Brown; Robert Vitti; Alyson J Berliner; Bo Gao; Oliver Zeitz; Rene Ruckert; Thomas Schmelter; Rupert Sandbrink; Jeff S Heier Journal: Ophthalmology Date: 2012-04-24 Impact factor: 12.079
Authors: Michael J Elman; Haijing Qin; Lloyd Paul Aiello; Roy W Beck; Neil M Bressler; Frederick L Ferris; Adam R Glassman; Raj K Maturi; Michele Melia Journal: Ophthalmology Date: 2012-09-19 Impact factor: 12.079
Authors: Quan Dong Nguyen; David M Brown; Dennis M Marcus; David S Boyer; Sunil Patel; Leonard Feiner; Andrea Gibson; Judy Sy; Amy Chen Rundle; J Jill Hopkins; Roman G Rubio; Jason S Ehrlich Journal: Ophthalmology Date: 2012-02-11 Impact factor: 12.079
Authors: Ranjan Rajendram; Samantha Fraser-Bell; Andrew Kaines; Michel Michaelides; Robin D Hamilton; Simona Degli Esposti; Tunde Peto; Catherine Egan; Catey Bunce; Richard David Leslie; Philip G Hykin Journal: Arch Ophthalmol Date: 2012-08
Authors: Nathan Congdon; Benita O'Colmain; Caroline C W Klaver; Ronald Klein; Beatriz Muñoz; David S Friedman; John Kempen; Hugh R Taylor; Paul Mitchell Journal: Arch Ophthalmol Date: 2004-04
Authors: Andrew Hendrick; Jesse Smith; Chris Stelton; Scott Barb; Jiong Yan; Blaine Cribbs; Nieraj Jain; Steve Yeh; G Baker Hubbard; Li He; Susov Dhakal; P Michael Iuvone Journal: Exp Eye Res Date: 2020-04-29 Impact factor: 3.467
Authors: Martha E Ryan; Ramachandran Rajalakshmi; Vijayaraghavan Prathiba; Ranjit Mohan Anjana; Harish Ranjani; K M Venkat Narayan; Timothy W Olsen; Viswanathan Mohan; Laura A Ward; Michael J Lynn; Andrew M Hendrick Journal: Ophthalmology Date: 2015-07-16 Impact factor: 12.079
Authors: Francisco J Pasquel; Andrew M Hendrick; Martha Ryan; Emily Cason; Mohammed K Ali; K M Venkat Narayan Journal: J Diabetes Sci Technol Date: 2015-12-29
Authors: Kathryn Fitch; Thomas Weisman; Tyler Engel; Adam Turpcu; Helen Blumen; Yamina Rajput; Purav Dave Journal: Am Health Drug Benefits Date: 2015-09
Authors: Carl W Baker; Adam R Glassman; Wesley T Beaulieu; Andrew N Antoszyk; David J Browning; Kakarla V Chalam; Sandeep Grover; Lee M Jampol; Chirag D Jhaveri; Michele Melia; Cynthia R Stockdale; Daniel F Martin; Jennifer K Sun Journal: JAMA Date: 2019-05-21 Impact factor: 56.272