Strengths and limitations of this study
This study suggests that there is a significant association between patients presenting with active R3 retinopathy (ie, requiring urgent laser therapy) and social deprivation within a large multi-ethnic urban UK population.
In this study, we have used a case-control design to compare patients presenting to the community Diabetic Screening Service with active R3 retinopathy against “non-R3” patients being referred to the hospital eye service on a non-urgent basis during the same time period. We recognize that IMD reference data are a geographical measure of deprivation, rather than an assessment of the individual per se; however since it is uncommon for an individual’s circumstances to differ widely from the local average the IMD score is regarded as a valid tool for assessing socio-economic health care inequalities. It is important to recognize that our study only included patients who presented to the hospital eye service and as such does not include patients who either DNA screening, or who failed to attend their first hospital outpatient appointment.