Awareness of eye conditions in diabetic patients and organizational aspects of a diabetic retinopathy screening

to study awareness of patients with type 1 and type 2 diabetes mellitus (DM) about eye conditions and necessary regular ophthalmological examination; to evaluate speed of a reader. Patients and Methods: the paper is a part of a study involving various clinics from five cities of the Russian Federation. 367 patients with DM (65.12% - women; mean age — 50.88±20.55 years) 34.88% and 65.12% of which had DM1 and DM2, respectively, were enrolled. Average duration of the disease was 9.02±7.22 years. 58.31% of the patients had a history of hypertension, and 13.08% had that of smoking. Ophthalmologists evaluated a two-field fundus photo encoding abnormalities as R0 — no diabetic retinopathy (DR), R1 — nonproliferative DR, R2 — preproliferative DR, and R3 — proliferative DR. All patients were interviewed with a questionnaire containing 9 questions about DM, DR, reasons for avoiding an ophthalmologist, and diabetes school attendance. The reader turned on a stopwatch and recorded time (in seconds) spent to evaluate each fundus photo. Results: 96.19% of subjects knew that diabetes affects vision and it even may lead to blindness (91.80%), as well as that blood sugar control will help to maintain visual function (96.46%). 42.19% of the respondents finished a diabetes school. 47.96% of the subjects defined DR appropriately, and 42.23% learned about it from an endocrinologist. Although 98.09% of patients were aware of an annual ophthalmological examination, only 50.96% of patients visited it. Main reasons of non-attendance are limited availability of an ophthalmologist (33.06%) and lack of time (31.69%). The patients assessed their knowledge of DM and DR on 6.42±1.98 and 2.46±2.41 scores, respectively. Knowledge of DM and DR was independent of age, gender, and educational level. DR awareness was independent of a diabetes school attendance (odds ratio: 1.048, 95% confidence interval: 0.960–1.143). On average, the reader needs 73.25±29.91 s to evaluate a photo. 89.78% of the fundus photos were graded as R0, R1, R2, and R3 in 90.7%, 5.3% and 4% of all DR eyes, respectively. Conclusion: the results demonstrated importance of DR screening considering prevalence and social significance of DM, as well as percentage of retinal abnormalities detected in asymptomatic patients. High informativity of two-field retinal photography and potential follow- up comparison of the images are advantages of the approach used as a screening. It is important to raise patients' awareness of DR, their motivation to visit an ophthalmologist annually, and availability of medical care. KEYWORDS: diabetes mellitus, retina, diabetic retinopathy, screening, fundus photography, prevalence, two-field photography, risk groups, maculopathy, awareness, questionnaire, diabetes school. FOR CITATION: Avanesova T.A., Oganezova J.G., Anisimova V.V., Baeva A.B., Doronichev R.A., Miaev D.H. Awareness of eye conditions in diabetic patients and organizational aspects of a diabetic retinopathy screening. Russian Journal of Clinical Ophthalmology. 2025;25(2):94– 102 (in Russ.). DOI: 10.32364/2311-7729-2025-25-2-3