Abstract

Introduction: Diabetes mellitus (DM) is thought to affect about 2 per 1,000 children and young people (CYP) in the UK. Although highly relevant for planning ophthalmic services including diabetic eye screening, the UK incidence of sight-threatening diabetic eye disease among CYP is unknown. Purpose: To determine the UK incidence of sight-threating diabetic eye disease in CYP as part of a wider programme examining screening. Methods: Patients younger than 19 years with DM (type 1 or 2) newly diagnosed with sight-threatening diabetic eye disease were ascertained by prospective active surveillance through BOSU from February 2015. Sight-threatening diabetic eye disease was defined as visually significant diabetic retinopathy (maculopathy, R2, R3), cataract or visual impairment due to DM. Results: Interim findings (21 of 24 months of surveillance) are reported. Eight CYP from 5 to 17 years were confirmed as having sight-threating diabetic eye disease (approximate incidence: 1.4 per 10,000 person-years at risk): 5 with cataracts, 2 with R2 diabetic retinopathy, 1 with maculopathy. No patients with proliferative diabetic retinopathy (R3) were reported. Conclusions: Our study indicates that the UK incidence of any sight-threating diabetic eye disease in CYP is extremely low, with no cases of proliferative diabetic retinopathy or visual impairment reported to date. As part of the Diabetic Eye disease in Childhood Study (DECS), we are also using data from diabetic eye screening programmes to examine the natural history of paediatric diabetic retinopathy. Using this information, we will assess whether the current NICE recommendation of annual screening for sight-threatening diabetic retinopathy from age 12 years is appropriate.