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. 2015 Dec;122(12):2457-64.
doi: 10.1016/j.ophtha.2015.07.010. Epub 2015 Sep 1.

Ocular Complications in Children with Diabetes Mellitus

Megan M Geloneck  1 , Brian J Forbes  2 , James Shaffer  3 , Gui-shuang Ying  3 , Gil Binenbaum  4
Affiliations

Ocular Complications in Children with Diabetes Mellitus

Megan M Geloneck et al. Ophthalmology. 2015 Dec.

Abstract

Purpose: The effectiveness of annual eye examinations in diabetic children is unclear. We sought to determine the prevalence and onset of ocular pathology in children with diabetes mellitus (DM), identify risk factors for ocular disease, and recommend a screening regimen for asymptomatic children.

Design: Retrospective, consecutive cohort study.

Participants: Children aged less than 18 years with type 1 or 2 DM examined over a 4-year period.

Methods: All children underwent a complete eye examination, including dilated fundoscopy and cycloplegic refraction. A literature review was performed, identifying the youngest reported age and shortest reported duration of DM before the diagnosis of diabetic retinopathy (DR).

Main outcome measures: Prevalence of DR, cataract, high refractive error, and strabismus.

Results: A total of 370 children (mean age, 11.2 years; range, 1-17.5 years) had 693 examinations, with a mean DM duration of 5.2 years (range, 0.1-16.2 years) and a mean hemoglobin A1c (HbA1c) of 8.6 (range, 5-≥14). No children had DR. A total of 12 children had cataract; 5 required extraction but were identified by decreased vision, not diabetic screening. A total of 19 children had strabismus; only 1 was microvascular paralytic strabismus. A total of 41 children had high refractive error. There were no associations between these conditions and duration or control of DM. In the literature, the youngest age at diagnosis of severe DR was 15 years, and the shortest duration of disease was 5 years.

Conclusions: Diabetic retinopathy is rare in children regardless of duration and control of DM. On the basis of our study and literature review, screening examinations for type 1 diabetes could begin at age 15 years or at 5 years after the diagnosis of DM, whichever occurs later, unless the child is judged by the endocrinologist as being at unusually high risk. Other ocular complications are identifiable through existing amblyopia screening methods.

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Conflict of interest statement

None of the authors has a conflict of interest to report.

Figures

Figure 1
Figure 1
Age at last examination of all 370 children with diabetes mellitus in reference to age at diagnosis of diabetes mellitus. DM, diabetes mellitus.
See this image and copyright information in PMC

References

    1. Prevention Cfdca. National Diabetes Fact Sheet: National Estimates and General Information on Diabetes and Prediabetes in the United States, 2011. Atlanta, GA: US Department of Health & Human Services, Centers for Disease Control and Prevention; 2011.
    1. Photocoagulation treatment of proliferative diabetic retinopathy. Clinical application of Diabetic Retinopathy Study (DRS) findings, DRS Report Number 8. The Diabetic Retinopathy Study Research Group. Ophthalmology. 1981;88(7):583–600. - PubMed
    1. Photocoagulation therapy for diabetic eye disease. Early Treatment Diabetic Retinopathy Study Research Group. JAMA. 1985;254(21):3086. - PubMed
    1. Panel Aaoor. Preferred Practice Pattern 2014: Diabetic Retinopathy. San Francisco: American Academy of Ophthalmology; 2003.
    1. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. The Diabetes Control and Complications Trial Research Group. N Engl J Med. 1993;329(14):977–86. - PubMed

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