Diagnosis Gaps Mark Retinopathy Care

A US systematic review found substantial losses across diabetic retinopathy screening, diagnosis awareness, referral, and follow-up.

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

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.

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.

Regular follow-up is essential due to the need for more frequent visits than screening.

Lack of awareness of diabetic retinopathy diagnosis is associated with longer diabetes duration and elevated A1C.

US adults with diabetes

Follow-up adherence is challenging due to competing health issues and the need for ongoing retinal care.

Implement community-designed digital health tools to enhance awareness and follow-up.
Utilize artificial intelligence-assisted diagnosis tools to improve screening accuracy.