An Eye for A Foot: Alarming Unawareness of Diabetic Retinopathy Among Diabetic Foot Patients

Abstract

This study aims to determine the awareness of diabetic retinopathy in patients hospitalized for diabetic foot ulcers, examine their clinical and demographic characteristics, and evaluate their treatment needs. In this prospective study, 62 consequent patients with diabetic foot ulcers who were hospitalized for further treatment in Diabetic Foot Department between June and August 2023 were subjected to ophthalmological examinations. Detailed anterior and posterior segment examinations were performed. Clinical and demographic characteristics and HbA1c levels were recorded. Thirty-nine patients (62.9%) were male and 23 (37.1%) were female. The mean age was 61 ± 11.4 years. The patients had diabetes mellitus (DM) for an average of 19.2 ± 9.6 years. The average HbA1c value of the patients was 9 ± 2.3%. Minor amputation was performed in 35 of 62 patients (56.5%) during treatment. Thirty-one patients (50%) were unaware of the risk of diabetic retinopathy. Of those “unaware” 31 patients, 26 (83.9%) had diabetic retinopathy. Diabetic retinopathy was detected in 57 patients (91.9%) and 3-month interval ophthalmological follow-up screening was recommended for 77 eyes. Eighty percent of the patients never had ophthalmological examination. Intravitreal (IV) injection was performed in 44 eyes, panretinal photocoagulation (PRP) in 2 eyes, and intravenous injection + PRP + vitreoretinal surgery in one eye. Diabetic foot ulcers and diabetic retinopathy are often accompanied by each other. Patients should be informed about this and strongly encouraged to undergo routine ophthalmological examinations, especially when they have advanced diabetic foot disease. Diabetic foot surgeons should keep in mind that a poor eye cannot detect diabetic foot problems.