The profile of sight-threatening diabetic retinopathy in patients attending a specialist eye clinic in Hangzhou, China

Background/aims: To examine the profile of diabetic retinopathy, awareness and self-help in patients attending a specialist eye clinic in Hangzhou, China. Methods: A total of 199 consecutive diabetic patients (Mean age=57 years, SD=11) attending eye clinic at the School of Medicine, Zhejiang University, Hangzhou were examined in a cross-sectional study. Clinical/demographic data were obtained from patients’ records. Fundus photographs obtained from each patient were graded using Early Treatment of Diabetic Retinopathy Study (ETDRS) criteria; severe non-proliferative, proliferative retinopathy and/or macular oedema (hard exudates/thickening around fovea) were classified as Sight Threatening Diabetic Retinopathy (STDR). OCT was used to confirm the diagnosis of macular oedema. Data on knowledge/awareness about diabetes and self-help/lifestyle were collected using a structured questionnaire. Results: STDR was found in 80% patients of whom 18% had visual acuity of ≤counting fingers in least one eye. Male gender, longer diabetic duration and use of insulin were significantly associated with STDR (p ≤0.05). Of the total, 41% patients reported that they were attending for the first time. Of all the first-time attendees, 67% had STDR. Also of all the first-time attendees, 14% were unclear whether diabetes affected their eyes. Fifty-one percent of patients who thought their diabetes was well-controlled had fasting blood sugar ≥6.5mmol/L (p <0.001). Of the total, 65% patients reported not doing ≥four hours/week of physical exercise. Conclusions: The majority of diabetic patients presented to this eye clinic suffered with late-stage retinopathy. Our results advocate the need to improve diabetic diagnosis, management and awareness and to set up eye screening for diabetics in Hangzhou, China.