Discussion
This study shows that patients presenting with R3 retinopathy have higher than predicted levels of social deprivation when compared to controls. This effect is independent of HbA1c level.
It has previously been demonstrated that Type 2 diabetes is more prevalent in deprived populations26–28 which may, in part, explain the increased number of deprived patients presenting with R3 retinopathy. It has also been shown that patients with higher levels of social deprivation are more likely to have worse glycemic control.29,30 This is reflected in an increase in mortality18,31 and an increase in micro vascular complications.30 In this study we found positive association between presence of R3 retinopathy and increased levels of HbA1c (11.5% in R3 patients and 8.4% in controls). However social deprivation was found to be a risk factor for the presentation of the R3 retinopathy, even when glycemic control was adjusted for.