Predictors of diabetic retinopathy in a community health center population

Abstract

Objective. To determine the predictors of diabetic retinopathy (DR) in a Federally Qualified Health Center population of patients.Research design and methods. We retrospectively evaluated 526 patients who were screened for DR in the first year of a newly implemented telemedicine program (July 2009 to June 2010). Through this program, a total of 139 patients were diagnosed with DR, whereas 387 patients were not and then served as the comparator group. Multivariate logistic regression was used to determine the predictors of DR in this cohort of patients. Results. After multivariate analysis, four positive predictors of DR were found: insulin use (adjusted odds ratio [AOR] 1.94 [1.17-3.22]), years with diabetes (AOR 1.22 [1.16-1.28]), A1C (AOR 1.15 [1.02-1.29]), and kidney disease (AOR 5.11 [2.33-11.20]). No variables were found to decrease the odds of DR. Conclusion. Among patients with diabetes, use of insulin therapy, longer duration of diabetes, presence of kidney disease, and higher A1C values increase the odds of DR. These preliminary data may suggest patients who are at higher risk of DR to further prioritize screening for DR with a newly implemented telemedicine program.