Delay in seeking medical care after the onset of symptoms in patients with sight-threatening diabetic retinopathy

Abstract Background Diabetic retinopathy (DR) is a common diabetes-associated complication and a primary cause of blindness. One of the critical factors affecting timely and effectual therapy for DR is the delay in treatment after the onset of symptoms. The present study aimed to investigate the reasons for the delay in the treatment of the condition and the risk factors associated with the delay. Methods We retrospectively reviewed data from 127 patients with sight-threatening diabetic retinopathy (STDR) treated at Qilu Hospital of Shandong University in China. Various forms of STDR were identified including severe non-proliferative DR, clinically significant macular edema (CSME) and proliferative DR(PDR). Information concerning demography, clinical, and socioeconomic status of the patients was gathered. Risk factors associated with the delay was evaluated using logistic regression analysis. Results Among 127 patients with STDR, 89.2% sought medical care one month after the onset of symptoms. Patients who sought for treatment 6 months post-symptom onset had significantly lower income and less knowledge about diabetic eye complications than those presenting within 6 months. Multivariate logistic regression analysis showed that never or infrequent routine examination for diabetic complications was associated with a long delay in seeking medical care (odds ratio 3.06, 95% CI 1.05-9.19, p <0.05; odds ratio 2.91, 95% CI 1.04-8.40, p <0.05). Conclusions Most STDR patients sought medical care one month after the onset of symptoms. Never or infrequent routine examination for diabetic complications was associated with a long delay. The results of the present study stress the necessity to implement educational programs on diabetic complications to encourage early medical care and prevent disastrous outcomes.