BSPED2011 Oral Communications Oral Communications 4 (4 abstracts)
Natural history of background retinopathy in children and young people with diabetes
Ambika Karthikeyan 1 , Navpreet Dhillon 3 , Andrew Castle 1 , Paul Dodson 2 , Wolfgang Hogler 1 , Jeremy Kirk 1 , Nils Krone 1 , Jacky Nolan 1 & Tim Barrett 1
1Birmingham Children’s Hospital NHS Foundation Trust, Birmingham, UK; 2Heart of England NHS Foundation Trust, Birmingham, UK; 3University Hospitals Birmingham Selly Oak Hospital, Birmingham, UK.
Aim: To describe the prevalence and natural history of retinopathy in a cohort of children and young people with type 1 diabetes attending a tertiary hospital diabetes clinic.
Methods: We analysed follow-up data from 2008 to 2010 on all children eligible for retinopathy screening using the ‘Twinkle’ diabetes database and the regional retinal screening database.
Results: 88% (149/169) of eligible children were screened in 2008, median age14 years, 52% male. The prevalence of retinopathy was 19.5% (30/149) (all background retinopathy grade R1). There was significant difference in median (range) duration of diabetes, 7.7 years (0.6–13.7) vs 5 years (0.2–12.5) (P<0.001) and median (range) HbA1C, 9.1% (7.2–14) vs 8.6% (5.6–13.1) (P=0.02), between the groups with and without retinopathy. At 2 years follow-up, 12/30 (40%) had unchanged retinopathy grade R1, 10/30 (33.3%) showed resolution of changes (R0), 1/30 progressed to maculopathy, and 7/30 had no follow-up data. Median (range) HbA1C in 2008 and 2010 for the groups with stable vs. resolved changes was similar, 9.1% (7.2–14) and 9.2% (7–14) vs. 9.5% (7.8–14) and 9.2% (8.7–14). Of the 119 without retinopathy in 2008, 27 (22.5%) had developed retinopathy within 2 years, including 1 with pre proliferative retinopathy and 1 with maculopathy. There were no significant differences in HbA1c between those who progressed to retinopathy and those who did not, 8.7% (7.1–13.1) vs. 8.6% (6.3–12.2).
Conclusion: The prevalence of background retinopathy in our cohort was comparable to previously published reports, with higher HbA1c and longer duration of diabetes being significant risk factors. On short term follow up, Grade 1 retinopathy is likely to resolve in a third of patients and remain unchanged in just over a third.
Volume 27
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Endocrine Abstracts
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