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

• Published in: Eye (London) 2016-07, Vol.30 (7), p.949-951
• Main Authors: Hamid, A, Wharton, H M, Mills, A, Gibson, J M, Clarke, M, Dodson, P M
• Format: Article
• Language: English
• Subjects: 692/699/2743/137/138; 692/699/3161/3175; Age Factors; Child; Clinical Study; Diabetes Mellitus, Type 1; Diabetes Mellitus, Type 2; Diabetic Retinopathy - diagnosis; Female; Humans; Laboratory Medicine; Male; Medical Audit; Medicine; Medicine & Public Health; Ophthalmology; Pharmaceutical Sciences/Technology; Photography; Practice Guidelines as Topic - standards; Retrospective Studies; Surgery; Surgical Oncology; United Kingdom; Vision Screening - standards; Visual Acuity
• ISSN: 0950-222X; 1476-5454
• DOI: 10.1038/eye.2016.59

Aim To assess whether the current starting age of 12 is suitable for diabetic retinopathy (DR) screening and whether diabetes duration should be taken into account when deciding at what age to start screening patients. Materials and methods A retrospective analysis of 143 patients aged 12 years or younger who attended diabetic eye screening for the first time in the Birmingham, Solihull and Black Country Diabetic Eye Screening Programme was performed. Results The mean age of the patients was 10.7 (7–12) years with 73 out of 143 aged below 12 years and 70 were 12 years of age. 98% had type 1 diabetes and mean diabetes duration was 5 (1 month–11 years) years. For those younger than 12 years, 7/73 (9.6%) had background DR (BDR), of these mean diabetes duration was 7 years (6–8). The youngest patient to present with DR was aged 8 years. In those aged 12 years, 5/70 (7.1%) had BDR; of these mean diabetes duration was 8 years (6–11). No patient developed DR before 6 years duration in either group. Conclusions The results show that no patient younger than the age of 12 had sight-threatening DR (STDR), but BDR was identified. Based on the current mission statement of the Diabetic Eye Screening Programme to identify STDR, 12 years of age is confirmed as the right age to start screening, but if it is important to diabetic management to identify first development of DR, then screening should begin after 6 years of diabetes diagnosis.