Prevalence of diabetic retinopathy in children and adolescents with type 1 diabetes in Helsinki, Finland, 7–15 years after diagnosis

Abstract

PurposeThe study focuses on the prevalence of diabetic retinopathy (DR) in children and adolescents who were diagnosed from 1999 to 2004 in Helsinki with type 1 diabetes (T1D) under the age of 15 years and subsequently photographed in 2011–2014.MethodsFundus images of the patients were taken as a part of clinical follow‐up at the Department of Pediatrics if aged 10–18 years, and at Herttoniemi Hospital if older than 18 years. Of the 238 patients, 201 (84%) were included in this retrospective study (another 23 patients had moved from Helsinki, one patient never attended the fundus photography sessions, two had not yet been photographed due to young age, 10 patients who were transferred to adult care did not attend screening as planned, and one patient had died). The presence and severity of DR was determined from 60° fundus images taken with a digital Canon CF‐60UD camera with a green filter by one observer (SG) using ETDRS classification. The eye with more advanced DR level represented the patient.ResultsOf the 201 patients, 106 (53%) were males. The median age at diagnosis of T1D was 8 (range, 0.8–14) years. At the time of fundus imaging the median age was 19 (range, 10–28) years, and the median T1D duration was 11 (range, 7–15) years. Altogether 123 (61%; 95%CI, 54–68) patients had DR of whom the majority (113; 92%; 95%CI, 86–96) had mild DR (level 20 or 35). One patient had neovascularization on the retina. The age of the youngest patient with DR was 10 years. Of the 10 patients who did not attend fundus imaging in adult care, nine had had no DR and one had level 20 DR when analyzed in the pediatric unit.ConclusionsOur results indicate that over half of the young T1D patients in Helsinki have DR after a median duration of 11 years.