Real-World Screening for Retinopathy in Youth With Type 1 Diabetes Using a Nonmydriatic Fundus Camera.

Area of Science:

• Ophthalmology
• Endocrinology
• Public Health

Background:

• Diabetic retinopathy (DR) is a significant complication of diabetes, particularly in young individuals.
• Early detection and management of DR are crucial to prevent vision loss.
• Screening protocols for pediatric and young adult populations with type 1 diabetes require accessible and efficient methods.

Purpose of the Study:

• To evaluate the efficacy of a portable retinal camera for diabetic retinopathy (DR) screening in diverse settings among children, adolescents, and young adults with type 1 diabetes.
• To identify risk factors associated with DR development in this cohort.

Main Methods:

• A cohort of 500 youth (aged 9-26 years) with type 1 diabetes underwent retinal imaging using a nonmydriatic fundus camera.
• Images were assessed remotely by a licensed ophthalmologist.
• Patient-reported questionnaires and medical chart reviews were used to gather data on risk factors.

Main Results:

• Diabetic retinopathy (DR) was identified in 2.04% of subjects, with the youngest affected individual aged 17.1 years.
• DR prevalence was significantly higher (6.5%) in those with diabetes duration exceeding 10 years.
• Elevated blood pressure in the preceding year was associated with DR in a subgroup of clinic-based patients.

Conclusions:

• Portable retinal camera screening is feasible and effective in various settings for youth with type 1 diabetes.
• Older adolescents and young adults (over 17 years) with longer diabetes duration (over 6 years) are at increased risk for DR.
• Elevated blood pressure is a potential risk factor for DR in this population.