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081 - Profil, craintes et motivation des patients atteints d’œdème maculaire diabétique en France

Patients with DME are often perceived as poorly compliant individuals who do not attend regular follow-up visits. A survey was henceforth undertaken to improve our understanding of the profile and motivations of such patients.

A random set of French retina specialists was selected in January 2017. Each physician was requested to propose a survey to 6 consecutive DME patients treated by intravitreal injections (IVTs). Physicians were asked to fill in medical information about diabetes (history of diabetes, type of diabetes and treatments) and about DME (history of DME, bilateral involvement, current and past DME treatments). A questionnaire was carried out on DME patients by phone interview to collect data on their professional status, daily activities, medical history before DME diagnosis, feelings and fears about DME and their consequences, impact of DME monitoring and treatments on daily life, and on  patients’ relationships with their ophthalmologist.

116 DME patients treated by IVTs were recruited by 87 French ophthalmologists during the first half of year 2017. Patients (mean age : 67 years, 60% male and 71% have type 2 diabetes) had been suffering from DME for 3.2 years (68% had bilateral involvement) and had been mainly treated by anti-VEGF (89%) for 2.4 years on average.

Only 41% of patients had a fundus examination by an ophthalmologist to detect diabetic retinopathy prior DME diagnosis. DME was mainly diagnosed during a follow-up consultation (44%) or after vision loss (37%). DME diagnosis induced lots of fears, 71% of the patients afraid of going definitively blind and losing their autonomy (mainly driving) and wondering when they would stop receiving recurrent IVT treatments. DME patients declared to be compliant with their monitoring and IVT appointments; whereas these consultations had an important impact on organization of their daily life (32% claimed an important impact). Nearly all (95%) of the DME patients declared having a good relationship with their ophthalmologist but still asked for more comprehensive and simple documents explaining their disease.

A Multiple Correspondence Analysis allowed identification of 3 types of DME patients : the worriers, the enquirers and the passives.

Patients with DME declared to be threatened by their visual future and claimed to be compliant with their monitoring and treatment appointments. They expected a more comprehensive explanation about their disease. They would develop different behaviors according to their fears and their needs of information.

The results of our survey provide new insights into the profile and motivations of DME patients, and may allow for a better approach for clinical management of these patients.