Diagnosis Gaps Mark Retinopathy Care
A US systematic review found substantial losses across diabetic retinopathy screening, diagnosis awareness, referral, and follow-up.
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By
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Andrea Surnit
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June 25, 2026
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Clinical Scorecard: Diagnosis Gaps Mark Retinopathy Care
At a Glance
| Category | Detail |
|---|
| Condition | Diabetic Retinopathy |
| Key Mechanisms | Cascade-of-care framework from diabetes diagnosis to diabetic retinopathy-related visual impairment and blindness. |
| Target Population | US adults with diabetes |
| Care Setting | Primary care and emergency department settings |
Key Highlights
- 70% of patients with photographic evidence of diabetic retinopathy were unaware of their diagnosis.
- Annual screening adherence ranged from 3% to 69%, with a median of about 47%.
- Only 52% of patients diagnosed with diabetic retinopathy were linked to ophthalmic care.
- Approximately 0.4% of patients with diabetic retinopathy had diabetic retinopathy-related blindness.
- Barriers to follow-up included younger age, systemic racism, and lack of insurance.
Guideline-Based Recommendations
Diagnosis
- At least annual diabetic retinopathy screening beginning at diagnosis for patients with type 2 diabetes.
- Screening should begin 5 years after diagnosis for patients with type 1 diabetes.
Management
- Patient navigation and teleophthalmology-based services may improve care.
Monitoring & Follow-up
- Regular follow-up is essential due to the need for more frequent visits than screening.
Risks
- Lack of awareness of diabetic retinopathy diagnosis is associated with longer diabetes duration and elevated A1C.
Patient & Prescribing Data
US adults with diabetes
Follow-up adherence is challenging due to competing health issues and the need for ongoing retinal care.
Clinical Best Practices
- Implement community-designed digital health tools to enhance awareness and follow-up.
- Utilize artificial intelligence-assisted diagnosis tools to improve screening accuracy.
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