Self-reported awareness of retinopathy severity in diabetic patients

Yaqoob Qaseem, Sahej Samra, Olga German, Elizabeth Gray, Manjot K. Gill*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Background: Diabetic retinopathy (DR) may be asymptomatic in both mild and advanced stages. A patient’s accurate perception of their DR severity may therefore be critical for effective self-management behaviors and understanding the need for timely intervention and follow-up. Purpose: To evaluate the relationship between self-reported and actual retinopathy severity in diabetic patients. Methods: This study was a single-center cross-sectional survey. Diabetic patients identified by enterprise data warehouse were sent an online questionnaire where they were asked to self-assess for presence of DR and grade their severity. Actual DR grading was determined via chart review. The primary outcome measures were patient-assessed DR severity and agreement with actual DR severity. Results: Of 3208 invitations sent, 324 (10%) patients responded and 319 responses were analyzed. The data showed that 39 of 253 (15%) with no DR, 26 of 40 (65%) with mild/ moderate DR, and 24 of 26 (92%) with severe DR believed they had DR (p<0.001). Of those with no DR, 214 of 253 (85%) accurately assessed absence of DR. Of those with mild/ moderate DR, 25 of 40 (63%) accurately assessed their severity, 14 of 40 (35%) believed they had no DR, and 1 of 40 (3%) believed they had severe DR. In patients with severe DR, 9 of 26 (35%) correctly assessed their severity, 15 of 26 (58%) believed they had mild/ moderate DR, and 2 of 26 (8%) believed they had no DR. Conclusion: Patients with severe DR were the most likely to report presence of DR, but often underestimated their disease severity. Many with mild/moderate DR did not realize they had DR. This consistent underestimation of severity across all a significant barrier to timely follow-up and treatment necessary to prevent future visual impairment.

Original languageEnglish (US)
Pages (from-to)2855-2863
Number of pages9
JournalClinical Ophthalmology
StatePublished - 2020


  • Accuracy
  • Anti-VEGF
  • Awareness
  • Barriers
  • Diabetes
  • Diabetic retinopathy
  • Perception
  • Screening
  • Self-report
  • Severity
  • Survey
  • Understanding

ASJC Scopus subject areas

  • Ophthalmology


Dive into the research topics of 'Self-reported awareness of retinopathy severity in diabetic patients'. Together they form a unique fingerprint.

Cite this