Screening for retinopathy in children and adolescents with type 1 diabetes mellitus

Diabetic retinopathy is a common cause of blindness in the United States. Fortunately, vision-preserving therapies are available when the disease process is detected early. While retinopathy screening is recommended by several expert panels, adherence to these guidelines is universally poor. In addition, the current guidelines for children may be too strict, resulting in a poor diagnostic yield and an unnecessarily high therapeutic and financial burden.\ud \ud Mydriatic fundal photography was implemented into routine clinical visits at The Children’s Hospital of Pittsburgh (CHP) so that the prevalence of childhood retinopathy could be measured while studying the impact of streamlined screening services on adherence. \ud \ud The prevalence of diabetic retinopathy in the study population was 2.4%. Subjects with retinopathy were older (17.1 vs. 15.3 years, p=0.05), with a longer duration of diabetes (10.2 vs. 7.1 years, p=0.007), and worse glycemic control (HbA1c 11.2% vs. 8.4%, p=0.008). Children who underwent screening through streamlined services at CHP were more likely to be African American (16% vs. 2%, p