incidence of Diabetic Macular Edema in type 1 Diabetes

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Abstract

Purpose

Diabetic retinopathy is a serious vision threatening complication which can be prevented if detected early.Since diabetic retinopathy has been reported to occur only rarely before the end of pubertal development, children and adolescents are seldom included in screening programmes. Our main goal is to screen for early retinal changes and review the risk factors involved in the development of diabetic retinopathy in children.

Methods

We prospectively enrolled 200 children and adolescents with insulin-dependent type 1 diabetes mellitus diagnosed before the age of15.0years(disease duration of < 12 years)and who were older than 5.0 years at the time of examination from our pediatric endocrinology clinics at 2 tertiary care hospitals(king abdulaziz university hospital and king faisal specialist hospital) in Jeddah,Saudia Arabia. all patients recived full eye examination including Best Corrected Visual Acuity,Retinal examination was performed with stereoscopic fundus examination by indirect ophthalmoscope for peripheral retinal changes and slit lamp exam with 75 D lens for macular edema.Ocular coherence tography(OCT)was performed for all patients to evaluate sub-clinical macular edema

Results

Non of our patients had proliferative diabetic retinopathy changes,we also did not see evidence of diabetic macular edema Mean diabetes duration was 3years and mean HbA1c was 6.5%.Mild non proliferative DR was diagnosed in 30 children (15 %), those with DR were significantly older(P < 10−3),had a longer duration of diabetes (P = 0.001),and had higher HbA1c(P = 0.15). After adjustment for age, only longer duration remained significantly associated with DR (P = 0.01).

Conclusion

mainstay of prevention is tight glycemic control with regular screening and fundus examination,with OCT if suspension

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