At What Age Should Children With T1D Begin Retinopathy Screenings?
Researchers are recommending delaying annual diabetic retinopathy screenings in children with type 1 diabetes until age 15 or five years after their diabetes diagnosis, whichever occurs later. Findings from the study are published in the journal Ophthalmology.
Some professional organizations recommend beginning annual diabetic retinopathy screenings as early as age 9 or from 3–5 years after diagnosis to detect vision loss early. Study investigators from The Children's Hospital of Philadelphia and Sheie Eye Institute conducted a retrospective study of 370 children <18 years old with type 1 and type 2 diabetes. All of the participants had received at least one screening exam between 2009–2013 and none were found to have diabetic retinopathy.
They discovered that in previous studies, diabetic retinopathy rates among children were between 0% and 28% with a majority of the cases being mild and not qualifying for treatment. The youngest severe case reported was between 15–19 years old and the earliest severe diabetic retinopathy case had developed 5–6 years post-diagnosis.
The prevalence of advanced forms of diabetic eye disease were low among children living with diabetes regardless of the disease duration or their ability to maintain glycemic control, researchers reported. Based on these findings, they recommend that children with type 1 diabetes could begin screenings later than previously recommended with the exception of high-risk patients (including children with type 2 diabetes).
Children with type 2 diabetes should start diabetic retinopathy screenings upon diagnosis in line with guidelines for adults with type 2 diabetes. The researchers note that a change in the recommendations can alleviate excessive financial and logistical burden for families and the healthcare system.
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