April 2014
Volume 55, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2014
Feasibility and Efficacy of Diabetic Retinopathy Screening Among Children with Diabetes
Author Affiliations & Notes
  • Jeffrey Tapley
    Ophthalmology, University of Alabama at Birmingham, Birmingham, AL
  • Gerald McGwin
    Epidemiology, University of Alabama at Birmingham, Birmingham, AL
  • Ambika Ashraf
    Pediatrics/Division of Endocrinology, University of Alabama at Birmingham, Birmingham, AL
  • Paul MacLennan
    Surgery, University of Alabama at Birmingham, Birmingham, AL
  • Koula Callahan
    Ophthalmology, University of Alabama at Birmingham, Birmingham, AL
  • Karen Searcey
    Ophthalmology, University of Alabama at Birmingham, Birmingham, AL
  • C. Douglas Witherspoon
    Ophthalmology, University of Alabama at Birmingham, Birmingham, AL
  • Jinan Saaddine
    Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, GA
  • Cynthia Owsley
    Ophthalmology, University of Alabama at Birmingham, Birmingham, AL
  • Footnotes
    Commercial Relationships Jeffrey Tapley, None; Gerald McGwin, None; Ambika Ashraf, None; Paul MacLennan, None; Koula Callahan, None; Karen Searcey, None; C. Douglas Witherspoon, None; Jinan Saaddine, None; Cynthia Owsley, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science April 2014, Vol.55, 5334. doi:
  • Views
  • Share
  • Tools
    • Alerts
      ×
      This feature is available to authenticated users only.
      Sign In or Create an Account ×
    • Get Citation

      Jeffrey Tapley, Gerald McGwin, Ambika Ashraf, Paul MacLennan, Koula Callahan, Karen Searcey, C. Douglas Witherspoon, Jinan Saaddine, Cynthia Owsley; Feasibility and Efficacy of Diabetic Retinopathy Screening Among Children with Diabetes. Invest. Ophthalmol. Vis. Sci. 2014;55(13):5334.

      Download citation file:


      © ARVO (1962-2015); The Authors (2016-present)

      ×
  • Supplements
Abstract

Purpose: To determine the feasibility and efficacy of the use of a non-mydriatic camera to screen for diabetic retinopathy (DR) among children with type 1 or type 2 diabetes mellitus. Recent work shows that only two-thirds of diabetic children receive an annual dilated eye exam, making it the least commonly followed of the American Diabetes Association guidelines for diabetes care in children. Non-mydriatic fundus cameras have been implemented as successful screening tools for DR in adults. These cameras are non-invasive, painless, and produce high-quality fundus photographs capable of detecting most clinically significant cases of DR. However, this approach has not been well studied in children.

Methods: Children with type 1 or 2 diabetes ages 8 to 18 years old who visited the UAB Pediatric Endocrinology Clinic for a routine appointment were invited to enroll. A non-mydriatic camera (Nidek Model AFC-230) was used to obtain fundus images of each eye. Walk-in visual acuity was assessed with a Titmus vision screener. A brief questionnaire was administered to the parent/guardian addressing the child’s diabetes and previous eye care utilization. Screening took place over an 8-week period. Fundus images were reviewed and graded by a retina specialist using the UK National Health Classification System for DR.

Results: A total of 236 patients were screened; average age was 14.1 years (SD 2.69), 135 (57.2%) were female, and 158 (67.0%) were Caucasian and 70 (29.7%) African American. Most of the patients had type 1 diabetes (85.6%) and average duration since diabetes diagnosis was 5½ years. Only 57 (24.2%) had 20/20 vision in both eyes and 156 (66.1%) reported having had a dilated eye examination within the previous year. Overall, DR was detected in 9 patients (3.8%), i.e., 7 patients had at least 1 eye graded as having background DR (a single eye for 6 and both eyes for 1); whereas 2 patients were graded as having proliferative DR in both eyes. Overall, 23 (9.7%) patients were referred to an ophthalmologist or other eye care provider.

Conclusions: This study shows the use of a non-mydriatic fundus camera is a feasible and efficacious method to screen for DR in children with diabetes. Screening programs may be beneficial in the management of diabetes in children and prevention of irreversible vision loss.

Keywords: 499 diabetic retinopathy • 463 clinical (human) or epidemiologic studies: prevalence/incidence • 550 imaging/image analysis: clinical  
×
×

This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.

×