PDB103 HUMANISTIC BURDEN ASSOCIATED WITH DIABETIC RETINOPATHY: EVIDENCE FROM A LITERATURE REVIEW

Abstract

Diabetic Retinopathy (DR) is the most common microvascular complication of diabetes. Globally DR is the leading cause of visual impairment and blindness among working-age adults. The aim of this study was to review literature on the humanistic burden associated with DR. A targeted literature search was performed for studies published in English from database inception to January 2019 in Embase, MEDLINE, MEDLINE-In Process, and Cochrane library. Studies reporting on the humanistic burden in adult DR patients were included. The review identified 57 studies from 60 publications. The 25-item National Eye Institute Visual Function Questionnaire (NEI VFQ 25) was the most frequently used instrument to assess vision related QoL (VRQoL). Literature findings indicated that DR has a significant negative impact on patients’ VRQoL, mental health, and activities of daily living (ADLs). VRQoL assessed using the NEI VFQ-25 showed significantly poorer QoL in DR patients compared to controls in the US (Proliferative DR [PDR] vs. controls: Mean score, 82.7 vs. 95.0), Japan (PDR vs. control: 52.8 vs. 85.0; p<0.0001), Sweden (PDR vs. control: 88.6 vs. 96.3), Australia (DR vs. control: 88.0 vs. 93.4) and India (DR vs. control: 73.9 vs. 99.2; p<0.0001). Generic QoL assessed using the SF-36 showed patients with DR had a worse physical component score to controls (77.1 vs. 84.1) whereas the mental component score was similar. In terms of ADLs, DR patients had greatest difficulty in reading small prints, labels and street signs compared to controls. An increased rate of depression (35% vs. 21.1%) was seen compared to controls and an inverse relationship between cognitive impairment and DR severity was observed. The presence of DR and visual impairment lead to significant impairment of VRQoL, physical components of HRQoL, ADLs and emotional well-being of patients. As impairment increases with disease severity, treatments that delay disease progression are warranted.