Diabetic retinopathy (DR) is a serious complication of diabetes that causes visual impairment and blindness in Japan. Adherence to follow-up services is a key component for effective DR management. However, the attendance rates for DR follow-ups and eye examinations are unknown. We assessed the rate of follow-up for ophthalmic examinations and factors associated with discontinuation of eye examinations for patients with type 2 diabetes. In total, 624 patients with type 2 diabetes mellitus (348 males, 276 females; age 63.5±12.8 years, HbA1c 7.1±0.9%) were included. After obtaining informed consent, a questionnaire and review of the medical records were used to obtain data regarding sex, diabetic complications, body mass index (BMI), diabetes treatment, periodic eye examinations at least once a year, alcohol consumption, smoking status, the quality of life instruments (Short Form 36: SF-36), brief depression measures (CES-D), and the Big Five Personality Test (TIPI-J). In total, 510 patients (82.6%) had undergone periodic eye examinations and 114 (18.4%) had not been examined for 1 year. Patients not having examinations (non-attendance) were older (p=0.04), with higher HbA1c levels (p=0.01), and higher depression (p=0.01), and were single (p=0.03). There was no significant association between the attendance and non-attendance groups regarding sex, BMI, alcohol consumption, smoking, or stages of DR. The non-attendance group had lower scores in vitality and mental health (using the SF-36) than the attendance group (p<0.01). The non-attendance group scored lower on the neuroticism scale compared to the attendance group (p=0.04). The attendance percentage for the DR group follow-up examinations was 82%. The non-attendance group had higher depression symptom scores, higher HbA1c levels, lower quality of life and neuroticism scores, were older, and more likely divorced or separated. Improving the use of follow-up services is needed, particularly regarding improved psychosocial aspects.


H. Murakami: None. H. Otaka: None. M. Murabayashi: None. S. Mizushiri: None. A. Kamba: None. Y. Matsuhashi: None. M. Yanagimachi: None. H. Nakayama: None. M. Daimon: None.

Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. More information is available at http://www.diabetesjournals.org/content/license.