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Pediatric diabetic retinopathy telescreening.
Sasha Strul1, Yuxi Zheng2, Sapna Gangaputra3
1Vanderbilt Eye Institute, Vanderbilt University, Nashville, Tennessee; Department of Ophthalmology and Visual Neurosciences, University of Minnesota, Minneapolis, Minnesota.
Summary
Telemedicine screening identified diabetic retinopathy (DR) in children. Longer diabetes duration and higher average glycated hemoglobin (HbA1c) increased DR risk, highlighting the value of remote screening for pediatric eye health.
Area of Science:
- Ophthalmology
- Endocrinology
- Digital Health
Background:
- Diabetic retinopathy (DR) is a significant complication of diabetes mellitus.
- Early detection and management are crucial to prevent vision loss in pediatric patients.
- Telemedicine offers a potential solution for expanding DR screening accessibility.
Purpose of the Study:
- To evaluate the effectiveness of telemedicine for screening pediatric diabetic retinopathy (DR).
- To identify key risk factors associated with the development of DR in children and adolescents.
Main Methods:
- Retrospective review of medical records from a 17-month telemedicine program at an academic medical center.
- Telescreening of patients aged 10-23 years attending a pediatric endocrinology clinic.
- Analysis of fundus photographs to detect DR and associated risk factors.
Main Results:
- Diabetic retinopathy was detected in 6% (51 of 852) of pediatric patients screened.
- Older age, longer diabetes duration, type 1 diabetes, and higher average HbA1c were associated with increased DR risk.
- Longer diabetes duration and higher average HbA1c remained significant risk factors after statistical adjustment.
Conclusions:
- The telemedicine program demonstrated a higher detection rate of DR compared to traditional ophthalmic examinations.
- Longer disease duration and elevated average HbA1c are significant predictors of DR in the pediatric population.
- Telemedicine is a viable tool for effective DR screening in children with diabetes.
