Published online February 1, 2006
PEDIATRICS Vol. 117 No. 2 February 2006, pp. 586 (doi:10.1542/peds.2005-2278)
This Article
Right arrow Extract Freely available
Right arrow Full Text (PDF)
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow E-mail this article to a friend
Right arrow Related articles in Pediatrics
Right arrow Similar articles in this journal
Right arrow Similar articles in Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrowRequest Permissions
Citing Articles
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Stefánsson, E.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Stefánsson, E.
Related Collections
Right arrow Ophthalmology
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Facebook   Add to Reddit   Add to Technorati   Add to Twitter  
What's this?

Diabetic Retinopathy Screening

Einar Stefánsson, MD, PhD
Department of Ophthalmology,
University of Iceland,
105 Reykjavík, Iceland

To the Editor.—

We read with interest the recent clinical report by Lueder et al, "Screening for Retinopathy in the Pediatric Patient With Type 1 Diabetes Mellitus."1 Systematic screening for diabetic retinopathy was introduced in Iceland in 1980 and includes almost all type 1 diabetic patients in the country. The program has been very successful, and the prevalence of legal blindness (visual acuity of <0.1) has been reduced from 2.5% in 1980 to 0.5% in 2005.2–4 Our database includes standardized charts and fundus photographs for almost the entire population of patients with type 1 diabetes, in most cases updated annually or biannually over the 25-year period.

We examined the prevalence of diabetic retinopathy in children with type 1 diabetes mellitus. At the time of the study in 1992, 46 diabetic patients in Iceland (population: 290000) were <15 years of age, and none had diabetic retinopathy.5 The youngest patient with diabetic retinopathy at any time in our screening program was 14 years old and past puberty. We also reported that no diabetic patients of any age went from no retinopathy to sight-threatening retinopathy (clinically significant diabetic macular edema or proliferative diabetic retinopathy) in ≤2 years. We concluded that biannual eye screening starting at age 12 was sufficient for diabetic patients without retinopathy2 and have been using this protocol successfully for 10 years.4 Kalm6 has suggested that the interval between diabetic eye screening could be as much as 3 to 5 years in patients with a short duration of diabetes mellitus. Annual eye screening for diabetic patients without retinopathy as suggested by Lueder et al and the American Academy of Pediatrics, American Academy of Ophthalmology, and the American Diabetes Association may be overambitious and, in too many cases, an unrealistic goal.

REFERENCES

  1. Lueder GT, Silverstein J; Section on Ophthalmology and Section on Endocrinology. Screening for retinopathy in the pediatric patient with type 1 diabetes mellitus. Pediatrics. 2005;116 :270 –273[Abstract/Free Full Text]
  2. Kristinsson JK. Diabetic retinopathy: screening and prevention of blindness—a doctoral thesis. Acta Ophthalmol Scand Suppl. 1997;(223):1–76
  3. Stefansson E, Bek T, Porta M, Larsen N, Kristinsson JK, Agardh E. Screening and prevention of diabetic blindness. Acta Ophthalmol Scand. 2000;78 :374 –385
  4. Zoega GM, Gunnarsdóttir Þ, Björnsdóttir S, Hreiðarsson ÁB, Viggósson G, Stefánsson E. Screening compliance and visual outcome in diabetes. Acta Ophthalmol Scand. 2005; In press
  5. Kristinsson JK, Gudmundsson JR, Stefansson E, Jonasson F, Gislason I, Thorsson AV. Screening for diabetic retinopathy: initiation and frequency. Acta Ophthalmol Scand. 1995;73 :525 –528
  6. Kalm H. Diabetic Retinopathy Screening: Method & Strategy [thesis]. Gothenburg, Sweden: Department of Ophthalmology, Sahlgren's Hospital, University of Gothenburg; 1993
PEDIATRICS (ISSN 1098-4275). ©2006 by the American Academy of Pediatrics

Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Facebook Facebook   Add to Reddit Reddit   Add to Technorati Technorati   Add to Twitter Twitter    What's this?

Related articles in Pediatrics:

Diabetic Retinopathy Screening: In Reply
Gregg T. Lueder
Pediatrics 2006 117: 586-587. [Extract] [Full Text]  




This Article
Right arrow Extract Freely available
Right arrow Full Text (PDF)
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow E-mail this article to a friend
Right arrow Related articles in Pediatrics
Right arrow Similar articles in this journal
Right arrow Similar articles in Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrowRequest Permissions
Citing Articles
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Stefánsson, E.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Stefánsson, E.
Related Collections
Right arrow Ophthalmology
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Facebook   Add to Reddit   Add to Technorati   Add to Twitter  
What's this?