A research team led by a CHOP eye surgeon suggests that routine retinal screening of children with type 1 diabetes can begin later than current guidelines recommend.
Although diabetic retinopathy (DR) can damage retinal tissue and seriously impair vision, the condition is very rare in children, regardless of how long they have had diabetes or how well they control their blood glucose levels, said study leader Gil Binenbaum, MD, a pediatric ophthalmologist at The Children’s Hospital of Philadelphia.
The researchers did a retrospective study of 370 children with type 1 and type 2 diabetes, all of whom had undergone at least one complete eye examination at CHOP between 2009 and 2013. None of the children had DR.
The researchers then reviewed the research literature to analyze the prevalence and onset of DR in children with type 1 diabetes. They concluded that screenings for most children could begin at age 15 or at five years after diabetes is diagnosed, whichever occurs later. Binenbaum added that exceptions should be made for children with type 2 diabetes, or for those with type 1 diabetes judged by their endocrinologist as being at unusually high risk.
Binenbaum and co-authors from the Scheie Eye Institute of the University of Pennsylvania published their findings online Sept. 1 in Ophthalmology.
Currently the American Academy of Pediatrics recommends annual DR screening exams for children with either type of diabetes at three to five years after diagnosis of diabetes or after age 9, whichever occurs later. However, because of the rarity of DR in children, and the financial and logistical burden of such screening exams, Binenbaum and colleagues suggest that those exams could safely be delayed for children with type 1 diabetes. They add that collaborative consensus groups should consider reevaluating their screening guidelines.
Read a news release from the American Academy of Ophthalmology describing this study.