OBJECTIVE To assess self-reported awareness of diabetic retinopathy (DR) and concordance of eye examination follow-up compared with findings from concurrent retinal images. RESEARCH DESIGN AND METHODS We conducted a prospective observational 10-year study of 26,876 consecutive patients with diabetes who underwent retinal imaging during an endocrinology visit. Awareness and concordance were evaluated using questionnaires and retinal imaging. RESULTS Awareness information and gradable images were available in 25,360 patients (94.3%). Severity of DR by imaging was as follows: no DR (n = 14,317; 56.5%), mild DR (n = 6,805; 26.8%), or vision-threatening DR (vtDR; n = 4,238; 16.7%). In the no, mild, and vtDR groups, 96.7%, 88.5%, and 54.9% of patients, respectively, reported being unaware of any prior DR. When DR was present, reporting no prior DR was associated with shorter diabetes duration, milder DR, last eye examination >1 year before, no dilation, no scheduled appointment, and less specialized provider (all P < 0.001). Among patients with vtDR, 41.2%, 58.1%, and 64.2% did not report being aware of any DR and follow-up was concordant with current DR severity in 66.7%, 41.3%, and 25.4% (P < 0.001) of patients when prior examination was performed by a retinal specialist, nonretinal ophthalmologist, or optometrist (P < 0.001), respectively. CONCLUSIONS Substantial discrepancies exist between DR presence, patient awareness, and concordance of follow-up across all DR severity levels. These discrepancies are present across all eye care provider types, with the magnitude influenced by provider type. Therefore, patient self-report should not be relied upon to reflect DR status. Modification of medical care and education models may be necessary to enhance retention of ophthalmic knowledge in patients with diabetes and ensure accurate communication between all health care providers.

中文翻译：

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远程视网膜成像结果与患者报告的糖尿病视网膜病变状态和后续眼部护理间隔之间的差异：一项 10 年前瞻性研究

目的 评估自我报告的糖尿病视网膜病变 (DR) 认知度以及眼科检查随访与同时视网膜图像结果的一致性。研究设计和方法 我们对 26,876 名连续糖尿病患者进行了一项为期 10 年的前瞻性观察研究，这些患者在内分泌科就诊期间接受了视网膜成像。使用问卷和视网膜成像评估意识和一致性。结果 25,360 名患者 (94.3%) 获得了意识信息和可分级图像。通过影像学检查 DR 的严重程度如下：无 DR（n = 14,317；56.5%）、轻度 DR（n = 6,805；26.8%）或威胁视力的 DR（vtDR；n = 4,238；16.7%）。在无 DR 组、轻度 DR 组和 vtDR 组中，分别有 96.7%、88.5% 和 54.9% 的患者表示不知道既往有任何 DR。当存在 DR 时，报告既往无 DR 与较短的糖尿病病程、较轻的 DR、最后一次眼科检查 > 1 年前、无散瞳、无预定预约以及不太专业的提供者相关（所有 P < 0.001）。在 vtDR 患者中，41.2%、58.1% 和 64.2% 的患者没有报告意识到任何 DR，并且随访结果与 66.7%、41.3% 和 25.4% 患者当前 DR 严重程度一致 (P < 0.001)当事先分别由视网膜专家、非视网膜眼科医生或验光师进行检查时（P < 0.001）。结论 所有 DR 严重程度的 DR 存在情况、患者意识和随访一致性之间存在显着差异。这些差异存在于所有类型的眼保健提供者中，其程度受提供者类型的影响。因此，不应依赖患者的自我报告来反映 DR 状态。可能有必要修改医疗保健和教育模式，以增强糖尿病患者对眼科知识的保留，并确保所有医疗保健提供者之间的准确沟通。