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diabetic_retinopathy [2025/06/16 14:23] – Scott Larsondiabetic_retinopathy [2026/05/26 19:33] (current) – [Table] Scott Larson
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 ====== Diabetic Retinopathy in Children ====== ====== Diabetic Retinopathy in Children ======
-FIXME+  * Uncommon in young children  
 +  * Microvascular complications  may become evident in adolescence 
 +    * 3-6% of Type I diabetes 
 +    * 9-10% in Type II diabetes 
 +  * Non-proliferative and vision-threatening retinopathy is rare before age 12 
 ====Recommendations for Eye Screening in Children with Diabetes==== ====Recommendations for Eye Screening in Children with Diabetes====
   * American Diabetes Association   * American Diabetes Association
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     * For Type II Diabetes     * For Type II Diabetes
       * First eye exam at the time of diagnosis then annually thereafter        * First eye exam at the time of diagnosis then annually thereafter 
 +====Ocular manifestations possible in Children====
 +===Non-proliferative retinopathy===
 +^ Stage        ^ Fundus Findings                                                                                                                     ^ Progress of Risk to Proliferative Retinopathy  ^
 +| Mild         | Microaneurysms only                                                                                                                 | 6% at 5 years                                  |
 +| Moderatge    | Microaneurysms + hemorrhages, hard exudates, cotton wool spots, venous beading, or IRMA                                             | 18% at 5 years                                 |
 +| Severe       | 4-2-1 rule (any of the following);hemorrhages in all 4 quadrants, venous beading in ≥2 quadrants, or prominent IRMA in ≥1 quadrant  | 50% in 1 year                                  |
 +| Very-Severe  | Two or more of the Severe features above                                                                                            | 100% at 4 years in one series                  |
 +===Proliferative retinopathy===
 +  * Early PDR 
 +    * new extraretinal vessels usually around the optic nerve (NVD) and retina (NVE)
 +  * High Risk PDR
 +    * NVD > 1/3 disc diameter 
 +    * NVD or NVE of any size with vitreous or pre-retinal hemorrhage 
 +  * Leads to tractional retinal detachment 
 +  * Neovascularization of the iris/angle  can lead to neovascular glaucoma 
 +  * 50% left untreated will have profound vision loss 
 +===Diabetic macular edema===
 +  * Important cause of vision loss associated with capillary non-profusion
  
 ====References==== ====References====