Knowledge, Clinical Staging, and Barriers to Early Presentation of Diabetic Retinopathy in a Tertiary Eye Care Centre in Ghana: A Cross-Sectional Study

加纳一家三级眼科中心糖尿病视网膜病变早期就诊的知识水平、临床分期及障碍:一项横断面研究

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Abstract

BACKGROUND AND AIMS: Diabetic retinopathy is the most common microvascular complication of diabetes mellitus and a leading cause of new-onset blindness in populations of working age. Late presentation of patients to eye care facilities has been associated with the development of vision-threatening complications. The study sought to determine the clinical profile, knowledge and factors influencing late presentation of diabetic retinopathy among diabetics at the Eye Centre of the Komfo Anokye Teaching Hospital in Ghana. METHODS: This descriptive cross-sectional study involved 78 diabetic patients referred to the retina clinic between February 2022 and April 2022. Participants underwent a comprehensive ocular examination, with the more severely affected eye used to determine the stage of DR based on the ETDRS classification. Data on socioeconomic status, knowledge of DR, and reasons for delayed presentation were collected using a structured, interviewer-administered questionnaire. Descriptive and inferential statistics were performed using SPSS version 23. Chi-square tests were used to assess associations, with statistical significance set at p < 0.05. RESULTS: Of the 78 participants, 36 (46.2%) were males and 42 (53.8%) females, with a mean age of 49.9 ± 11.4 years. The mean knowledge score on DR was 5.3 ± 3.2 (out of 12). Most participants (65%) were aware that uncontrolled diabetes affects the eyes. Clinical grading showed that 7.7% had mild NPDR, 16.7% moderate NPDR, 10.3% severe NPDR, 19.2% very severe NPDR, 9.0% high-risk PDR, and 37.2% had advanced PDR. The most cited reason for delayed presentation was lack of knowledge about DR (69.2%). CONCLUSION: The majority of diabetic patients presented with advanced stages of DR, primarily due to limited awareness about the condition. Strengthening public education and routine screening may help reduce late presentations and prevent vision loss.

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