MONITORING FOR RETINOPATHY IN CHILDREN AND ADOLESCENTS WITH TYPE-1 DIABETES

In children with an average diabetes onset at 11 y of age, the first r etinal changes can be expected after a median diabetes duration of 9 y , while the median time until clinically relevant background retinopat hy is 14 y. Periodic examinations of the retinal status become necessa ry with the onset of puberty or after 5 y of diabetes duration. Only s ensitive methods should be used for retinopathy screening; the minimum recommended standard is a stereoscopic slit-lamp biomicroscopic exami nation in mydriasis. The degree of glycaemic control, both before and after puberty, appears to be of outstanding importance for the develop ment of retinopathy, but the contribution of other factors (arterial b lood pressure, lipid abnormalities, sex steroids, smoking and genetic factors) may be of varying relevance in the individual patient. Thus, to improve the long-term prognosis for children with diabetes appropri ate screening for retinopathy and associated risk factors is mandatory .