Patient self-report of prior laser treatment reliably indicates presence of severe diabetic retinopathy.

Kleins Lab // Publications // Mar 01 2009

PubMed ID: 19054495

Author(s): Grassi MA, Mazzulla DA, Knudtson MD, Huang WW, Lee KE, Klein BE, Nicolae DL, Klein R. Patient self-report of prior laser treatment reliably indicates presence of severe diabetic retinopathy. Am J Ophthalmol. 2009 Mar;147(3):501-4. doi: 10.1016/j.ajo.2008.09.016. Epub 2008 Dec 3. PMID 19054495

Journal: American Journal Of Ophthalmology, Volume 147, Issue 3, Mar 2009

PURPOSE To determine whether patient self-report of prior laser treatment can be used as a reliable tool for assessing the presence of severe diabetic retinopathy.

DESIGN This was a retrospective study on two groups of diabetic subjects.

METHODS One hundred patients with diabetes were recruited from the general eye and retina clinics at the University of Chicago Hospitals. The patients were asked, “Have you ever received laser treatment for your diabetic eye disease (DED)?” A chart review was then conducted noting if the patient had received either focal laser treatment for diabetic macular edema or panretinal photocoagulation for proliferative diabetic retinopathy. Data from the Wisconsin Epidemiological Study of Diabetic Retinopathy (WESDR) were also analyzed. Participant responses to the question “Have you had laser photocoagulation treatment for your eyes?” were analyzed with documentation of photocoagulation scars determined by grading seven-standard field color fundus photographs.

RESULTS In the University of Chicago group, 96 of 100 (96%) of patients were accurate in reporting whether they had received previous laser treatment for DED (sensitivity 95.8%, specificity 96.1%, and positive predictive value 88.5%). In the WESDR analysis, 2,329 of 2,348 (99%) of participants were accurate in reporting whether they had prior laser treatment for DED (sensitivity 96.0%, specificity 99.5%, and positive predictive value 95.6%).

CONCLUSIONS The high sensitivity and specificity of our results validate the use of patient self-report as a useful tool in assessing past laser treatment for severe diabetic retinopathy. Patient self-report may be a useful surrogate to clinical examination or medical record review to determine the presence of severe diabetic retinopathy.