Macular recovery during onset and development of diabetic retinopathy in childhood and adolescence

Abstract

The relationship between the macular recovery recorded by nyctometry and the retinal findings was examined in 60 initially pre-pubescent children with insulin-dependent diabetes mellitus during a 6-year period with special reference to the clinical applicability of nyctometry in selecting children and adolescents at risk of developing proliferative diabetic retinopathy. At the end of the study period the mean age of the patients was 21.9 years (range 18-23 years) and the mean diabetes duration 13.2 years (range 8.1-21.2 years). At the initial recording of macular recovery, only 7% of the children showed retinopathy, and this only in the form of a few microaneurysms or dot haemorrhages. During the study period, however, nearly all (93%) developed retinopathy, and in 9 (14%) the disease progressed into proliferative retinopathy. The initially recorded macular recovery time (MRI) of those children developing proliferative retinopathy was significantly lower (616 +/- 95; X +/- SEM) compared to the initial MRT performances (900 +/- 47) of the rest of the children. However, due to a high coefficient of variation in the material; predictive sensitivity showed low (56%) at a specificity level of 90%, suggesting that nyctometry is less suitable for selecting risk patients in children than in adults.