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Refraction and retinopathy in diabetic children below 16 years of age
J Johansen1, A K Sjølie, O Eshøj
1Department of Ophthalmology, Arhus University Hospital, Denmark.
Insights
Diabetic children rarely have eye complications. Cycloplegic refraction is recommended for accurate myopia detection in pediatric diabetes evaluations.
Area of Science:
- Ophthalmology
- Pediatrics
- Endocrinology
Background:
- Insulin-dependent diabetes mellitus (IDDM) can lead to various complications.
- Ophthalmological complications, particularly retinopathy and refractive errors, are concerns in diabetic children.
- Early detection and management are crucial for preserving vision.
Purpose of the Study:
- To assess the prevalence of retinopathy and refractive errors in children with IDDM.
- To compare the accuracy of refractive error detection with and without cycloplegia.
- To establish optimal methods for refractive evaluation in this population.
Main Methods:
- A cross-sectional study involving 42 children with IDDM (median age 11 years, median diabetes duration 4 years).
- Ophthalmological examinations including visual acuity and funduscopy.
- Biochemical assessment using HbA1c.
- Refractive error assessment using both non-mydriatic and cycloplegic refraction.
Main Results:
- No participants exhibited visual loss due to diabetes.
- Mild, non-proliferative retinopathy was observed in only 4.8% of children.
- Cycloplegic refraction identified low-degree myopia (<-2D) in 12% of patients, compared to 29% with non-mydriatic measurements.
Conclusions:
- Diabetic retinopathy and visual loss are uncommon in this cohort of children.
- Cycloplegic refraction significantly increases the detection rate of myopia in diabetic children.
- Cycloplegia is essential for accurate refractive error assessment in pediatric diabetes patients.
Abstract:
In a population-based cross-sectional study of insulin-dependent diabetes mellitus, 42 children--with a median age of 11 years (range 7-15 years) and a median duration of diabetes of 4 years (range 1-12 years)--underwent an ophthalmological and a biochemical examination (HbA1c). None of the children had visual loss due to diabetes, and only 4.8% had mild, non-proliferative retinopathy. Using cycloplegic refractioning, we found low degree myopia (less than -2D) in 12% of the patients, whereas non-mydriatic measurements increased the frequency of myopia to 29%. We therefore recommend the use of cycloplegia in refractive evaluations of diabetic children.