Focus on diabetic retinopathy in adolescents

Focus on diabetic retinopathy in adolescents

Authors

  • Ahmed Kassem Sanford Health, University of North Dakota
  • Collin Asheim University of North Dakota

Keywords:

Diabetes, diabetic retinopathy, telemedicine, screening, fundus photography, artificial intelligence, Diabetes, Diabetic retinopathy, telemedicine, screening, fundus photography , Artificial Intelligence

Abstract

 

Abstract.

Background and aim: Diabetic retinopathy (DR) is a vision threatening and preventable complication of diabetes (DM) that was historically rare in the pediatric population but increasing incidence is noted in the adolescent age group.

Methods: In this review, we present the etiology, magnitude of the problem, challenges to screening and new opportunities for early detection

Results: The incidence of diabetic retinopathy in children with type 2 DM (T2DM) is estimated to be 6.99% 5 years from diagnosis and the risk of DR in T2DM is twice as much as in T1DM and is significantly higher after puberty. Smart phone-based screening has reported sensitivity and specificity for any DR being 52-92.2% and 73.3-99% respectively. The use of Artificial Intelligence has high sensitivity and specificity for identifying DR greater than 94% and 86% respectively

Conclusions: Diabetic retinopathy is increasingly noted in children and adolescents necessitating reconsideration of current guidelines. Technologies such as Smartphone-compatible devices, telemedicine, and use artificial intelligence (AI) show promise in overcoming anticipated shortage in healthcare professionals available for screening.

References

Cioana M, Deng J, Nadarajah A, et al. Global Prevalence of Diabetic Retinopathy in Pediatric Type 2 Diabetes: A Systematic Review and Meta-analysis. JAMA. 2023 Mar 1;6(3):e231887. doi: 10.1001/jamanetworkopen.2023.1887

CDC. Centers for Disease Control and Prevention. 2022 [cited 2023 Nov 5]. By the Numbers: Diabetes in America. Available from: https://www.cdc.gov/diabetes/health-equity/diabetes-by-the-numbers.html

D’Souza D, Empringham J, Pechlivanoglou P, Uleryk EM, Cohen E, Shulman R. Incidence of Diabetes in Children and Adolescents During the COVID-19 Pandemic: A Systematic Review and Meta-Analysis. JAMA. 2023 Jun 1;6(6):e2321281. doi: 10.1001/jamanetworkopen.2023.21281

Wu H, Patterson CC, Zhang X, et al. Worldwide estimates of incidence of type 2 diabetes in children and adolescents in 2021. Diabetes Res Clin Pract. 2022 Mar;185:109785. doi: 10.1016/j.diabres.2022.109785

Abela AG, Fava S. Why is the Incidence of Type 1 Diabetes Increasing? Curr Diabetes Rev. 2021;17(8):e030521193110. doi: 10.2174/1573399817666210503133747

Cioana M, Deng J, Nadarajah A, et al. The Prevalence of Obesity Among Children With Type 2 Diabetes: A Systematic Review and Meta-analysis. JAMA. 2022 Dec 15;5(12):e2247186. doi: 10.1001/jamanetworkopen.2022.47186

Lueder GT, Silverstein J, and Section on Ophthalmology and Section on Endocrinology. Screening for Retinopathy in the Pediatric Patient With Type 1 Diabetes Mellitus. Pediatrics. 2005 Jul 1;116(1):270–3. doi: 10.1542/peds.2005-0875

Solomon SD, Chew E, Duh EJ, et al. Diabetic Retinopathy: A Position Statement by the American Diabetes Association. Diabetes Care. 2017 Mar;40(3):412–8. doi: 10.2337/dc16-2641

Wang W, Lo ACY. Diabetic Retinopathy: Pathophysiology and Treatments. Int J Mol Sci. 2018 Jun 20;19(6):1816. doi: 10.3390/ijms19061816

Wong TY, Sun J, Kawasaki R, et al. Guidelines on Diabetic Eye Care: The International Council of Ophthalmology Recommendations for Screening, Follow-up, Referral, and Treatment Based on Resource Settings. Ophthalmology. 2018 Oct;125(10):1608–22. doi: 10.1016/j.ophtha.2018.04.007

Cheung N, Mitchell P, Wong TY. Diabetic retinopathy. Lancet. 2010 Jul 10;376(9735):124–36. doi: 10.1016/S0140-6736(09)62124-3

Cheloni R, Gandolfi SA, Signorelli C, Odone A. Global prevalence of diabetic retinopathy: protocol for a systematic review and meta-analysis. BMJ. 2019 Mar 3;9(3):e022188. doi: 10.1136/bmjopen-2018-022188

Zheng Y, He M, Congdon N. The worldwide epidemic of diabetic retinopathy. Indian J Ophthalmol. 2012;60(5):428–31. doi: 10.4103/0301-4738.100542

Hietala K, Harjutsalo V, Forsblom C, Summanen P, Groop PH. Age at Onset and the Risk of Proliferative Retinopathy in Type 1 Diabetes. Diabetes Care. 2010 Jun;33(6):1315–9. doi: 10.2337/dc09-2278

Bai P, Barkmeier AJ, Hodge DO, Mohney BG. Ocular Sequelae in a Population-Based Cohort of Youth Diagnosed With Diabetes During a 50-Year Period. JAMA Ophthalmology. 2022 Jan 1;140(1):51–7. doi: 10.1001/jamaophthalmol.2021.5052

Shukla UV, Tripathy K. Diabetic Retinopathy. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 [cited 2023 Nov 5]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK560805/

Mishra C, Tripathy K. Fundus Camera. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 [cited 2023 Nov 14]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK585111/

Kárason KT, Vo D, Grauslund J, Rasmussen ML. Comparison of different methods of retinal imaging for the screening of diabetic retinopathy: a systematic review. Acta Ophthalmol. 2022 Mar;100(2):127–35. doi: 10.1111/aos.14767

Bedard C, Sherry Liu S, Patterson C, Gerstein H, Griffith L. Systematic review: Can non-mydriatic cameras accurately detect diabetic retinopathy? Diabetes Res Clin Pract. 2017 Jul;129:154–9. doi: 10.1016/j.diabres.2017.04.024

Yan W, McGuinness M, Chakrabarti R, Fotis K, Finger RP. Comparison of Photographic Screening Methods for Diabetic Retinopathy - A Meta-analysis. Ophthalmic Epidemiol. 2023 Jun;30(3):221–9. doi: 10.1080/09286586.2022.2065311

Hu J, Chen R, Lu Y, et al. Single-Field Non-Mydriatic Fundus Photography for Diabetic Retinopathy Screening: A Systematic Review and Meta-Analysis. Ophthalmic Res. 2019;62(2):61–7. doi: 10.1159/000499106

Govinda A, de Verteuil R. Systematic review of the diagnostic accuracy of the single, two and three field digital retinal photography for screening diabetic retinopathy. JBI Libr Syst Rev. 2011;9(16):491–537. doi: 10.11124/01938924-201109160-00001

Gräsbeck TC, Gräsbeck SV, Miettinen PJ, Summanen PA. Fundus Photography as a Screening Method for Diabetic Retinopathy in Children With Type 1 Diabetes: Outcome of the Initial Photography. Am J Ophthalmol 2016 Sep 1;169:227–34. doi: 10.1016/j.ajo.2016.06.037

Thapa R, Sharma S, Pradhan E, et al. Prevalence and associated factors of diabetic retinopathy among people with diabetes screened using fundus photography at a community diabetic retinopathy screening program in Nepal. BMC Ophthalmol. 2023 Oct 23;23:429. doi: 10.1186/s12886-023-03173-z

Avidor D, Loewenstein A, Waisbourd M, Nutman A. Cost-effectiveness of diabetic retinopathy screening programs using telemedicine: a systematic review. Cost Eff Resour Alloc. 2020;18:16. doi: 10.1186/s12962-020-00211-1

Khan T, Bertram MY, Jina R, Mash B, Levitt N, Hofman K. Preventing diabetes blindness: cost effectiveness of a screening programme using digital non-mydriatic fundus photography for diabetic retinopathy in a primary health care setting in South Africa. Diabetes Res Clin Pract. 2013 Aug;101(2):170–6. doi: 10.1016/j.diabres.2013.05.006

Egunsola O, Dowsett LE, Diaz R, Brent MH, Rac V, Clement FM. Diabetic Retinopathy Screening: A Systematic Review of Qualitative Literature. Can J Diabetes. 2021 Dec;45(8):725-733.e12. doi: 10.1016/j.jcjd.2021.01.014

Appukumran R, Shyamsundar K, Agrawal M, Khurana R, Pannu A, Kumar P. Eight years’ experience in mobile teleophthalmology for diabetic retinopathy screening. Med Hypothesis Discov Innov Ophthalmol. 2023 Feb 3;11(4):162–70. doi: 10.51329/mehdiophthal1460

Jones S, Edwards RT. Diabetic retinopathy screening: a systematic review of the economic evidence. Diabet Med. 2010 Mar;27(3):249–56. doi: 10.1111/j.1464-5491.2009.02870.x

Ting DSW, Cheung GCM, Wong TY. Diabetic retinopathy: global prevalence, major risk factors, screening practices and public health challenges: a review. Clin Exp Opthalmol. 2016;44(4):260–77. doi: 10.1111/ceo.12696

31. Prayogo ME, Zaharo AF, Damayanti NNR, et al. Accuracy of Low-Cost, Smartphone-Based Retinal Photography for Diabetic Retinopathy Screening: A Systematic Review. Clin Ophthalmol. 2023;17:2459–70. doi: 10.2147/OPTH.S416422

Tan R, Teo KYC, Husain R, et al. Evaluating the outcome of screening for glaucoma using colour fundus photography-based referral criteria in a teleophthalmology screening programme for diabetic retinopathy. Br J Ophthalmol. 2024 Jun 20;108(7):933-939. doi: 10.1136/bjo-2023-323339.

Nunez do Rio JM, Nderitu P, Raman R, et al. Using deep learning to detect diabetic retinopathy on handheld non-mydriatic retinal images acquired by field workers in community settings. Sci Rep. 2023 Jan 25;13:1392. doi: 10.1038/s41598-023-28347-z.

Liu R, Li Q, Xu F, et al. Application of artificial intelligence-based dual-modality analysis combining fundus photography and optical coherence tomography in diabetic retinopathy screening in a community hospital. Biomed Eng Online. 2022 Jul 20;21:47. doi: 10.1186/s12938-022-01018-2.

Wroblewski JJ, Sanchez-Buenfil E, Inciarte M, et al. Diabetic Retinopathy Screening Using Smartphone-Based Fundus Photography and Deep-Learning Artificial Intelligence in the Yucatan Peninsula: A Field Study. J Diabetes Sci Technol. 2023 Aug 29;19322968231194644. doi: 10.1177/19322968231194644.

Dong X, Du S, Zheng W, Cai C, Liu H, Zou J. Evaluation of an Artificial Intelligence System for the Detection of Diabetic Retinopathy in Chinese Community Healthcare Centers. Front Med (Lausanne). 2022 Apr 11;9:883462. doi: 10.1177/19322968231194644.

Xue W, Zhang J, Ma Y, et al. Deep learning-based analysis of infrared fundus photography for automated diagnosis of diabetic retinopathy with cataracts. J Cataract Refract Surg. 2023 Oct;49(10):1043. doi: 10.1097/j.jcrs.0000000000001269.

Bellemo V, Lim G, Rim TH, et al. Artificial Intelligence Screening for Diabetic Retinopathy: the Real-World Emerging Application. Curr Diab Rep. 2019 Jul 31;19(9):72. doi: 10.1007/s11892-019-1189-3.

Downloads

Published

29-10-2024

Issue

Section

PEDIATRICS AND ADOLESCENT MEDICINE

How to Cite

1.
Kassem A, Asheim C. Focus on diabetic retinopathy in adolescents. Acta Biomed. 2024;95(5):e2024100. doi:10.23750/abm.v95i5.16353