Patient characteristics and physician referral patterns for management of diabetic retinopathy by pars plana vitrectomy at Fujita Health University

Purpose: To evaluate patient characteristics and physician referral patterns for pars plana vitrectomy to manage diabetic retinopathy. Methods: We conducted a questionnaire survey of 272 patients with diabetic retinopathy who underwent pars plana vitrectomy at Fujita Health University between November 2003 and January 2005. The patients were assigned to one of 2 groups: those with proliferative diabetic retinopathy (PDR group) who had vitreous hemorrhage, traction retinal detachment, or neovascular glaucoma, and those who underwent surgery to manage diabetic macular edema (ME group). Referral to an ophthalmologist by a physician in a clinic versus a hospital was also examined. Results: More patients in the PDR group than in the ME group had stopped or missed ocular examinations. About 45% of the ME group underwent vitrectomy while continuing routine eye care. The mean preoperative HbA1c value for the PDR group (8.1±2.1%) was higher than that of the ME group (7.2±1.3%) (p<0.01, Student's t-test). The proportion of patients referred to ophthalmologists from general physicians in clinics was lower than the proportion referred by general physicians in hospitals. Approximately 60% of patients were referred because of symptoms such as decreased vision. Conclusion: Patient compliance with diabetes care and ophthalmic follow-up examinations and physician referral patterns for vitrectomy to manage diabetic retinopathy need to be improved to prevent loss of vision in diabetic patients.