A PROSPECTIVE, LONGITUDINAL-STUDY EXAMINING THE DEVELOPMENT OF RETINOPATHY IN CHILDREN WITH DIABETES

A prospective longitudinal study of 182 children and adolescents with diabetes revealed that during a follow-up of 2.5 +/- 0.5 years the pre valence of retinopathy increased from 10.8% to 28.0%, corresponding to an annual increase of 7%. Retinopathy was diagnosed at a mean age of 15.3 years (95% CI, 14.8-15.8 years) after a mean duration of diabetes of 8.9 years (95% CI, 8.0-9.7 years). Prepubertal years of diabetes c ontributed to the risk of developing retinopathy. The initial signs of retinopathy were microaneurysm(s) in 56%, microaneurysm(s) and haemor rhage(s) in 30%, and haemorrhage(s) in 10%. A combination of microaneu rysm, haemorrhage and cotton-wool spot was observed in 2%, and microan eurysms, haemorrhage and an IRMA lesion were seen in 2%. Most of the i nitial lesions disappeared during the follow-up period, but at the sam e time new lesions developed elsewhere in the retina in all but 2 case s. In 8 patients (15% of patients with retinopathy) aged 13.7-19.8 yea rs and having had diabetes for 3.7-14.8 years, retinal changes progres sed from mild to a more advanced background retinopathy. A higher glyc ated haemoglobin level during puberty was the only factor which differ entiated these patients from control patients matched for sex, age, pu berty and duration of diabetes.