Purpose: To describe the role of telemedicine screening for pediatric diabetic retinopathy (DR) and to identify risk factors for pediatric DR. Methods: The medical records of a telemedicine program at a tertiary, academic medical center over 17 months were reviewed retrospectively. Patients visiting an academic pediatric endocrinology clinic who met guidelines underwent telescreening. Presence of pediatric DR and risk factors for retinopathy were evaluated. Results: The fundus photographs of 852 patients 10-23 years of age were reviewed. Diabetic retinopathy was noted in 51 (6%). Patients with an abnormal screening photograph were compared to patients with diabetes who had normal screening photographs (n = 64). Older age, longer diabetes duration, type 1 diabetes, and higher average glycated hemoglobin (HbA1c) from the year prior to the photograph were associated with increased risk of retinopathy. Of these, longer duration (P = 0.003) and higher average A1c (P = 0.02) were significant after adjusting for sex, race, and age. Conclusions: Our telemedicine program found a higher percentage of diabetic retinopathy screening non-mydriatic photographs than prior studies found through standard ophthalmic examinations. In this relatively small sample size, longer duration of disease and higher average A1c were associated with increased risk of having diabetic retinopathy in our study.
Bibliographical noteFunding Information:
This work was partially supported by an unrestricted grant to the Department of Ophthalmology and Visual Sciences at Vanderbilt University Medical Center from Research to Prevent Blindness , New York, NY, and by the Kids Battle Diabetes Golf Classic and the Care Foundation of America , whose support made possible the purchase non-mydriatic retinal cameras and facilitated expansion of retinal screening to off-campus locations of the Children's Diabetes Program at Vanderbilt.
© 2020 American Association for Pediatric Ophthalmology and Strabismus
Copyright 2020 Elsevier B.V., All rights reserved.