DIABETIC RETINOPATHY: A SYSTEMATIC REVIEW OF DEVELOPMENTAL FACTORS IN ADULTS TREATED IN PRIMARY HEALTH CARE

Abstract

Diabetic retinopathy (DR) is one of the main microvascular complications of diabetes mellitus, being a common cause of irreversible vision loss in adults. DR affects about one-third of diabetics, with a progression divided into nonproliferative and proliferative stages, with complications associated with retinal neovascularization. PHC plays a crucial role in prevention and early diagnosis, however, it faces challenges such as lack of infrastructure, lack of ophthalmologists in primary care, and difficulties in articulating between the levels of care of the Unified Health System (SUS). Factors such as low socioeconomic status, advanced age, presence of comorbidities, and longer time since diagnosis are determinants in the development of DR. Therefore, this study seeks to contribute to the understanding of risk factors and improve care strategies for this population. Thus, it is a systematic review of the literature, of an observational, qualitative and cross-sectional nature. The search was based on the Lilacs (Latin American and Caribbean Literature on Health Sciences), PubMed (US National Library of Medicine National Institutes of Health), SciELO (Scientific Electronic Library Online), EMBASE, Scopus and Science Direct databases, using the search terms "Diabetes Mellitus", "Diabetic Retinopathy", "Primary Health Care", and their synonyms. In all, six articles were reviewed. The analysis of the studies was organized into two categories: one that evaluated the structure of the health system and the patient's social issue, and the other that included physiological aspects involved in the development of DR. Thus, it was observed that the evolution of diabetic retinopathy in Primary Health Care is related to multidimensional factors, such as the absence of DR screening and poor metabolic control.