Epidemiology of visual impairment, sight-threatening or treatment-requiring diabetic eye disease in children and young people in the UK: findings from DECS. Issue 5 (14th June 2020)

• Record Type: Journal Article
• Authors: Ibanez-Bruron, Maria Carolina; Solebo, Ameenat Lola; Cumberland, Phillippa; Rahi, Jugnoo S
• Is Part Of: British journal of ophthalmology. Volume 105:Issue 5(2021)
• Page Start: 729
• Page End: 734
• Publication Date: 2020-06-14
• Subjects: Child health (paediatrics) -- Lens and zonules -- Epidemiology -- Diagnostic tests/Investigation -- Public health -- Vision; Ophthalmology -- Periodicals; 617.7
• DOI: 10.1136/bjophthalmol-2020-315886
• Languages: English
• ISSNs: 0007-1161

Abstract

Abstract : Background: We investigated the incidence and causes of sight-threatening diabetes-related eye disease in children living with diabetes in the UK, to inform the national eye screening programme and enable monitoring of trends. Methods: We undertook a prospective active national surveillance via the British Ophthalmic Surveillance Unit. Eligible cases were children aged 18 years or younger, with type 1 or 2 diabetes, newly diagnosed between January 2015 and February 2017 with sight-threatening diabetic eye disease. Results: Eight children were reported. The annual incidence of all sight-threatening diabetes-related eye disease requiring referral to an ophthalmologist among children living with diabetes (n=8) in the UK was 1.21 per 10 000 person-years (95% CI 0.52 to 2.39) and was largely attributable to cataract (n=5) 0.76 per 10 000 person-years (95% CI 0.25 to 1.77). The incidence of sight-threatening diabetic retinopathy (n=3) among those eligible for screening (12 to 18 year-olds living with diabetes) was 1.18 per 10 000 person-years (95% CI 0.24 to 3.46). No subjects eligible for certification as visually impaired or blind were reported. Conclusions: Secondary prevention of visual disability due to retinopathy is currently the sole purpose of national eye screening programmes globally. However, the rarity of treatment-requiring retinopathy in children/young people living with diabetes, alongside growing concerns about suboptimal screening uptake, merit new consideration of the utility of screening for primary prevention of diabetes-related morbidity by using the screening event and findings as a catalyst for better diabetes self-management.