Pediatric diabetic retinopathy: experience of a tertiary hospital in Ethiopia

Abstract

BackgroundDiabetic retinopathy is one of the micro vascular complications of diabetes mellitus. To date there are no studies that show the magnitude of diabetic retinopathy in the pediatric population of Ethiopia with only very few in Africa. The purpose of this study was to determine the prevalence of diabetic retinopathy in children and adolescents at a tertiary center in Ethiopia.MethodsThis cross-sectional hospital based descriptive study included children aged between 9 and 17 years attending the endocrine follow-up clinic of Tikur Anbesa Specialized Hospital. A structured questionnaire was used for evaluating sociodemographic data and information pertinent to diabetes. The prevalence of diabetic retinopathy was determined by fundus photography of each eye.ResultsA total of 86 patients were examined with a mean age of 13.7 (SD = 1.8) years. At onset of diabetes, 95.6 % of children presented with diabetic ketoacidosis(DKA); 22 children (25.6 %) had at least two episodes of DKA, and 45 children (52.3 %) had poor glycemic control. Background retinopathy was present in four children (4.7 %) with a mean age of 14.25 (SD = 1.89) years and two of them also had maculopathy.ConclusionAlthough there are some methodological limitations, this study highlights the difficulties of achieving good glycemic control and the early occurrence of diabetic retinopathy in Ethiopian diabetic children.

Incidence and predictors of diabetic ketoacidosis among children with type 1 diabetes mellitus in Western Amhara Referral Hospitals, Northwestern Ethiopia, 2018: A Retrospective Follow-Up Study

“…Moreover, this study found that the cumulative incidence and incidence density rate amon chldren with type 1 DM was lower than compared with findings in Tikur Anbessa Specialized hospital (74.4%) [37] and than that of Tanzania (89.9%) [11], Benin teaching hospital (77.1%) [24], Romania (67%), Taiwan (65%) [36]. The lower cumulative incidence might be explained by the improved diabetes education and prevention programs that have been implemented over the last decades.…”

High rates of ocular complications in a cohort of Haitian children and adolescents with diabetes

“…12,13 In a study of 86 children with type 1 DM from Ethiopia, 4.7% fulfilled the diagnosis for background DR, using fundus photography through dilated pupils performed by nurses. 13 It is unclear if the photographs were reviewed by an ophthalmologist.…”

“…1 A few reports have raised concern that children of non-Caucasian ancestry may develop ophthalmic complications precociously. [6][7][8][9][10][11] However, only sparse data on the topic is available in children of Abbreviations: BMI, body mass index; CDC, Centre for Disease Control; DR, diabetic retinopathy; DM, diabetes mellitus; kg, kilogram; m, meter; SD, standard deviation; IU, international units African ancestry living in low-resource setting, 12,13 and no study exists in children of Haitian descent. Such data is essential to provide adequate screening and early detection of ocular complications in the goal to avoid the irreversible consequence of visual impairment or blindness.…”

Change in peripapillary and macular choroidal thickness change in children with type 1 diabetes mellitus without visual impairment or diabetic retinopathy

“…; Shibeshi et al. ). Moreover, reports on early diabetic CT and screening indicators in children and adolescents are even scarcer.…”

“…At present, American Academy of Ophthalmology (AAO) only recommends that detection the levels of blood pressure, blood glucose and HBA1c may reduce the risk of development and progress of DR, and patients with DM undergo annual fundus examination 5 years after initial diagnosis (Taban et al 2009). However, there are few studies on the individual risk factors related to DR in paediatric patients with diabetes and blood glucose, HBA1c and diastolic blood pressure are the only confirmed risk factors (Broe et al 2014;Shibeshi et al 2016). Moreover, reports on early diabetic CT and screening indicators in children and adolescents are even scarcer.…”