Experiences and Perspectives on Diabetic Retinopathy Screening and Treatment in Mexico: A Subanalysis of the Diabetic
Ingrid Y Pita-Ortiz1, Raul Velez-Montoya2, Marlon García Roa3
1Retina and Vitreous Department, Fundación Hospital Nuestra Señora de la Luz, Mexico City, Mexico.
Introduction:
Diabetic retinopathy (DR) and diabetic macular edema (DME) are leading causes of vision loss worldwide and represent a growing public health concern in Mexico. Despite the availability of effective treatments, including anti-vascular endothelial growth factor (anti-VEGF) therapies, adherence and persistence remain suboptimal, compromising outcomes. This study, part of the international DR Barometer project, examined the perspectives of patients, healthcare providers, and clinic staff to better understand challenges and opportunities in DR/DME care delivery in Mexico.
Methods:
A cross-sectional, survey-based study was conducted across five high-volume ophthalmology clinics in Mexico. Standardized, paper-based questionnaires were completed anonymously by patients with DR or DME, healthcare providers, and clinic staff. Data were collected between October and November 2023, scanned, and analyzed descriptively.
Results:
A total of 1151 participants were included: 558 patients with DME, 265 patients with DR, 122 providers, and 206 clinic staff. Key barriers to adherence included financial burden of treatment (reported by 67.4% of patients with DME; emphasized by 97.5% of providers), logistical difficulties such as travel and long waiting times, and emotional concerns about being a burden to family (71.5% of patients with DME; 61.1% of patients with DR). Nonadherent patients were more likely to prioritize competing health issues and report limited support from care teams. While most patients stated that eye treatment was a priority (87-91%), only 61% of providers believed this to be true. Opportunities highlighted across stakeholders included proactive provider-patient communication, continuity of care with the same clinical team, appointment reminders, and financial assistance. Clinic staff emphasized the need for improved educational materials and better coordination of diabetes and eye care services.
Conclusions:
This study reveals substantial challenges to adherence in DR/DME management in participating Mexican referral centers, rooted in financial, logistical, and psychosocial factors. Strengthening communication, expanding financial support, and integrating coordinated, patient-centered care strategies could improve long-term treatment engagement and outcomes.
