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Abstract：
To report the prevalence and contributing factors of undiagnosed diabetic retinopathy (DR) in a population from Northeastern China.
A total of 800 subjects from the Fushun Diabetic Retinopathy Cohort Study were enrolled. A questionnaire assessing incentives and barriers to diagnosis of DR was administered. Logistic regression was used to identify clinical and sociodemographic factors associated with undiagnosed DR. In a prespecified subgroup analysis, we divided patients into vision-threatening diabetic retinopathy (VTDR) and non-VTDR (NVTDR) subgroups.
Among 800 participants with DR, 712 (89.0%) were undiagnosed. Among 601 with NVTDR, 566 (94.2%) were undiagnosed. Among 199 with VTDR, 146 (73.4%) were undiagnosed. The risk factors affecting the timely diagnosis of NVTDR and VTDR exhibit significant disparities. In multivariate models, factors associated with undiagnosed VTDR were age over 60 years (OR = 2.966; 95% CI = 1.205-7.299; P = 0.018), duration of diabetes over 10 years (OR = 0.299; 95% CI = 0.118-0753; P = 0.010), visual impairment or blindness (OR = 0.310; 95% CI = 0.117-0.820; P = 0.018), receiving a reminder to schedule an eye examination (OR = 0.380; 95% CI = 0.163-0.883; P = 0.025), and the belief that \"people with diabetes are unlikely to develop an eye disease\" (OR = 4.691; 95% CI = 1.116-19.724; P = 0.035). However, none of the factors were associated with undiagnosed NVTDR (all P ≥ 0.145).
Our research has uncovered a disconcerting trend of underdiagnosis in cases of DR within our population. Addressing determinants of undiagnosed DR may facilitate early detection.
A total of 800 subjects from the Fushun Diabetic Retinopathy Cohort Study were enrolled. A questionnaire assessing incentives and barriers to diagnosis of DR was administered. Logistic regression was used to identify clinical and sociodemographic factors associated with undiagnosed DR. In a prespecified subgroup analysis, we divided patients into vision-threatening diabetic retinopathy (VTDR) and non-VTDR (NVTDR) subgroups.
Among 800 participants with DR, 712 (89.0%) were undiagnosed. Among 601 with NVTDR, 566 (94.2%) were undiagnosed. Among 199 with VTDR, 146 (73.4%) were undiagnosed. The risk factors affecting the timely diagnosis of NVTDR and VTDR exhibit significant disparities. In multivariate models, factors associated with undiagnosed VTDR were age over 60 years (OR = 2.966; 95% CI = 1.205-7.299; P = 0.018), duration of diabetes over 10 years (OR = 0.299; 95% CI = 0.118-0753; P = 0.010), visual impairment or blindness (OR = 0.310; 95% CI = 0.117-0.820; P = 0.018), receiving a reminder to schedule an eye examination (OR = 0.380; 95% CI = 0.163-0.883; P = 0.025), and the belief that \"people with diabetes are unlikely to develop an eye disease\" (OR = 4.691; 95% CI = 1.116-19.724; P = 0.035). However, none of the factors were associated with undiagnosed NVTDR (all P ≥ 0.145).
Our research has uncovered a disconcerting trend of underdiagnosis in cases of DR within our population. Addressing determinants of undiagnosed DR may facilitate early detection.
摘要：
■报告中国东北地区未诊断的糖尿病视网膜病变（DR）的患病率和影响因素。
■共有800名来自富顺糖尿病视网膜病变队列研究的受试者被纳入。进行了评估DR诊断的动机和障碍的问卷。使用Logistic回归来确定与未诊断的DR相关的临床和社会人口统计学因素。在预设的亚组分析中，我们将患者分为威胁视力的糖尿病视网膜病变(VTDR)和非VTDR(NVTDR)亚组.
■在800名DR参与者中，712例（89.0％）未诊断。在具有NVTDR的601中，566例（94.2%）未确诊。在使用VTDR的199人中，146例（73.4%）未确诊。影响NVTDR和VTDR及时诊断的危险因素存在显著差异。在多变量模型中，与未确诊的VTDR相关的因素是年龄超过60岁(OR=2.966;95%CI=1.205-7.299;P=0.018),糖尿病病程超过10年(OR=0.299;95%CI=0.118-0753;P=0.010),视力障碍或失明(OR=0.310;95%CI=0.117-0.820;P=0.018),收到安排眼部检查的提醒(OR=0.380;95%CI=0.163-0.883;P=0.025),以及“糖尿病患者不太可能发生眼部疾病”的信念（OR=4.691；95％CI=1.116-19.724；P=0.035）。然而,所有因素均未与未诊断的NVTDR相关(P均≥0.145)。
■我们的研究揭示了我们人群中DR病例诊断不足的令人不安的趋势。解决未诊断的DR的决定因素可能有助于早期检测。
■共有800名来自富顺糖尿病视网膜病变队列研究的受试者被纳入。进行了评估DR诊断的动机和障碍的问卷。使用Logistic回归来确定与未诊断的DR相关的临床和社会人口统计学因素。在预设的亚组分析中，我们将患者分为威胁视力的糖尿病视网膜病变(VTDR)和非VTDR(NVTDR)亚组.
■在800名DR参与者中，712例（89.0％）未诊断。在具有NVTDR的601中，566例（94.2%）未确诊。在使用VTDR的199人中，146例（73.4%）未确诊。影响NVTDR和VTDR及时诊断的危险因素存在显著差异。在多变量模型中，与未确诊的VTDR相关的因素是年龄超过60岁(OR=2.966;95%CI=1.205-7.299;P=0.018),糖尿病病程超过10年(OR=0.299;95%CI=0.118-0753;P=0.010),视力障碍或失明(OR=0.310;95%CI=0.117-0.820;P=0.018),收到安排眼部检查的提醒(OR=0.380;95%CI=0.163-0.883;P=0.025),以及“糖尿病患者不太可能发生眼部疾病”的信念（OR=4.691；95％CI=1.116-19.724；P=0.035）。然而,所有因素均未与未诊断的NVTDR相关(P均≥0.145)。
■我们的研究揭示了我们人群中DR病例诊断不足的令人不安的趋势。解决未诊断的DR的决定因素可能有助于早期检测。
