Epidemiology, risk factors and management of paediatric diabetic retinopathy: Table 1

Abstract

Diabetic retinopathy (DR), a common complication of both type 1 and type 2 diabetes, is rarely expressed at a level greater than background retinopathy during childhood and adolescence. Epidemiological studies in paediatric diabetic patients together with data from the Diabetes Control and Complications Trial have demonstrated the importance of glycaemic control in delaying or preventing the development of DR; thus, the incidence of DR has declined somewhat over the past two decades. Both prepubertal and postpubertal years with diabetes contribute to the overall probability of DR development. In addition to duration of disease and degree of glycaemic control, other risk factors for DR development include elevated blood pressure, lipid profiles, serum levels of advanced glycation endproducts, evidence for early stage atherosclerosis, increased calibre of retinal blood vessels and several genetic factors, such as enzymes involved in glucose and lipid metabolism. Annual screening is recommended, with mydriatic stereoscopic fundus photography being the most sensitive detection method. Both pathophysiology and treatment in paediatric populations are essentially the same as described for adult populations, with treatment usually not required until adulthood is reached.

Pediatric diabetic retinopathy: experience of a tertiary hospital in Ethiopia

“…The International Society for Pediatric and Adolescent Diabetes (ISPAD) suggests that annual screening for retinopathy to be conducted in patients aged 11 years after diabetes of 2 years’ duration and from 9 years of age with diabetes of 5 years’ duration [4, 5]. …”

Diagnosis of retinopathy in children younger than 12 years of age: implications for the diabetic eye screening guidelines in the UK

“…5,7,8,10,11,13 The decision on what age to start DR screening will be determined by the mission statement of a DR screening programme. 7,14 If it is to detect STDR, then our data support 12 years of age to be the right age as demonstrated in our population. However, if it is important to identify first detection of development of DR, for example, to review diabetes medical management, then ideally DR screening should start 6 years after the onset of childhood diabetes.…”

“…9 Previous studies have been carried out to assess DR prevalence in young patients. The majority of these studies showed that a small percentage of patients younger than 12 years developed DR. 7,10,11 The main aim of the audit was to assess whether the current starting age is appropriate in relation to identification of STDR. A secondary aim was to determine whether diabetes duration should be taken into account when deciding at what age to start screening for DR in children.…”

“…[4][5][6][7] However, DR can occur before puberty and adolescence, which are high risk periods for DR progression. 1,4,8 The NHS Diabetic Eye Screening Programme in the UK states that all people with diabetes aged 12 years and older should be offered screening for STDR.…”

Serum concentrations of selected chemokines (CXCL1/GROα and CXCL8/IL8) in patients with type 1 diabetes

“…Retinopatia cukrzycowa (DR) stała się najczęstszą przyczyną ślepoty czy utraty ostrości wzroku u pacjentów w wieku produkcyjnym i jej występowanie wykazuje na ciągły wzrost [3][4]. Zmiany na dnie oka jawne klinicznie występują również u młodych pacjentów z T1DM [5][6]. W badaniach z Oxford Regional Prospective Study (ORPS) wykazano, że u dzieci i młodzieży z T1DM częstość późnych powikłań naczyniowych była wyższa niż u dorosłych po podobnym czasie trwania cukrzycy oraz z porównywalnymi średni-mi poziomami glikemii [6].…”