Evolution of ophthalmological care in adult with diabetes in France between 2010 and 2022: a nationwide study.

Purpose: The aim of this study is to describe ophthalmological care of adults with diabetes in France and its evolution between 2010 and 2022.

Methods: In this study, we used the ESND, a representative permanent random sample of 2/100th of the entire French population. Ophthalmological care was defined by the combination of ophthalmological procedures (fundus examination, color fundus photography, Optical Coherence Tomography..) and/or ophthalmological treatment (intravitreal injection or laser treatment) during the year. Changes in annual rates during the study period were assessed using linear regression models excluding 2020.

Results: From 2010 to 2022, the number of adults treated for diabetes in the ENSD increased from 48 329 patients (mean age 65.3 ± 13.0, 46.3% women) to 68 397 patients (mean age 67.0 ± 13.2, 44.8% women). Among them, the annual rate of ophthalmological care was stable (46.5% in 2010 and 48.5% in 2022) and the difference was not significant (β = 0.10% per year, p = 0.11). The yearly ophthalmological treatment rate increased significantly (3.3% in 2010 and 5.3% in 2022, β = 0.2% per year, p < 0.0001). Rates were lower during the COVID-19 outbreak in 2020.Women, individuals aged between 66-80 years, those living in the least deprived areas and those treated with combined insulin and non-insulin treatment had higher yearly ophthalmological care rate.

Conclusion: In this large nationwide representative study with recent and updated data, although ophthalmological treatment rate has increased over the decade mainly due to intravitreal injections, less than half of the diabetic patients receive yearly ophthalmological care.