Risk factors associated with urgent ophthalmic reference in diabetic patients

Diabetic retinopathy (DR) being a leading cause of blindness. Identifying the risk factors for patients with a higher risk of vision loss is crucial.

To identify the risk factors for urgent referrals in diabetic patients through an ophthalmic examination program.

Specific criteria for urgent referral were established to facilitate attendance. Risk factors related to urgent referral were evaluated in a multiple logistic regression model.

A total of 1,265 patients were screened. 678 (54%) had DR, 245 (19.4%) had diabetic macular edema, and 124 (10%) had visually significant cataracts. 399 (31.4%) patients needed urgent referral. Significant risk factors for urgent referral were 10 to 20 years from diabetes diagnosis (OR = 5.71, p < 0.001), more than 20 years from diabetes diagnosis (OR = 15.36, p < 0.001), high systolic blood pressure (OR = 1.66 per mmHg, p = 0.003), and high HbA1c (OR = 1.15, p = 0.002), after adjusting for sex and age.

A third of the patients require urgent referral. Main causes of urgent referral were DME, severe or worse DR, cataract and high intraocular pressure. Principal risk factors were diabetes duration, systolic blood pressure and HbA1c.