Background The purpose of this study was to determine the clinical features of patients with type 2 diabetes, and less ophthalmic examinations, referred by general physicians to ophthalmologists. the 327 patients, 102 had diabetic retinopathy (31.2%), with a mean best-corrected visual acuity of 0.0370.36 logMAR (logarithm of the minimum angle of resolution) units. Of the 327 patients, 203 were in the never-examined group and 124 were in TC-E 5001 the noncompliant group. The incidence of diabetic retinopathy in the noncompliant group was significantly higher than that in the never-examined group (P<0.001). Best-corrected visual acuity in the noncompliant group was significantly worse than in the never-examined group (P=0.004). Glycosylated hemoglobin levels and estimated glomerular filtration rate in the noncompliant group were significantly lower than in the never-examined group (P<0.001 and P<0.003, respectively); serum creatinine levels and urine albumin/creatinine ratio were significantly higher (P=0.020 and P=0.001, respectively). The severity of the diabetic retinopathy was significantly correlated with compliance in terms of ophthalmic examinations and with urine albumin/creatinine ratio (multiple regression analysis, P=0.047 and P<0.001, respectively). Conclusion Our results show that diabetic patients referred from general physicians due to less ophthalmic examinations generally have good visual acuity, but one third of them have diabetic retinopathy. A history of missing ophthalmic examinations and albuminuria are risk factors TC-E 5001 for diabetic retinopathy. Keywords: diabetic retinopathy, general physician, ophthalmologists, albuminuria Introduction Diabetic retinopathy (DR) is a serious Rabbit Polyclonal to EIF2B4 microvascular complication of diabetes mellitus and a major cause of decreased vision in working-aged adults.1 The risk of a severe decrease in vision can be reduced by effective control of serum glucose and by regular ophthalmic examinations for early detection and appropriate treatment, such as laser photocoagulation.2C6 Guidelines for frequency TC-E 5001 of ophthalmic examinations for early detection and timely treatment have been published.7 However, several studies have reported that more than one third of diabetic patients did not follow the guidelines,8 and low compliance with ophthalmic examinations was the cause of decreased vision even if vitreous surgery had been performed.9 Therefore, better communication with general physicians is necessary to encourage better compliance with regular ophthalmic follow-up examinations. This has been shown to be true in many patients who have less regular ophthalmic examinations even when they have regular general examinations for diabetes.10 Several large cohort studies have reported three major risk factors for DR, ie, duration of diabetes,11C13 circulating glycosylated hemoglobin (HbA1c) levels,11C15 and blood pressure.16C20 However, to the best of our knowledge, little has been reported on the clinical features of diabetic patients referred from general physicians due to less ophthalmic examinations. Thus, the purpose of this study was to determine the features of diabetic patients referred from general physicians to the Kansai Medical University Takii Hospital for evaluation of the eyes. Patients and methods Patients The procedures used in this study conformed to the tenets of the Declaration of Helsinki. A total of 327 consecutive patients with type 2 diabetes referred from general physicians to the Department of Ophthalmology, Kansai Medical University or college Takii Hospital (Osaka, Japan) between April 2009 and March 2012 were studied. Patients who have been referred from ophthalmologists or continued to have regular ophthalmic TC-E 5001 examinations at least once a yr were excluded. At the initial examination, all individuals were interviewed concerning their medical history, including any ocular diseases. All underwent a standard ophthalmic exam, including best-corrected visual acuity (BCVA), refraction, slit-lamp exam, and fundus exam with dilated pupils. BCVA was identified as the decimal visual acuity and then converted to logMAR (logarithm of the minimum amount angle of resolution) devices for statistical analysis. In cases where the eyes experienced different BCVA ideals, the eye with the lower BCVA was used. The individuals were divided into two organizations,9 ie, those with a history of missing ophthalmic examinations at our hospital or additional ophthalmic clinics for more than a yr (noncompliant group) and those without any earlier ophthalmic examination since the onset of diabetes mellitus (never-examined group). Classification of DR and diabetic status The stage of DR was determined by ophthalmoscopy and fluorescein angiography. The individuals were classified relating to.