In adults, there has been a decline in the incidence of diabetic retinopathy (DR) associated with improvements in diabetes management. Data on incident severe DR in adolescents are sparse. In our established diabetes complications assessment service, we recorded nine cases of sight-threatening retinopathy in youth aged 15–17.9 years from 2017 to 2021. Proliferative retinopathy and clinically significant macular oedema were identified. The subjects were diagnosed with type 1 diabetes before the age of 10 years and had a history of poor glycaemic control (HbA1c 86-130 mmol/mol, 10%–15%). Five cases of retinopathy developed rapidly within 2.5 years of a previously normal retinal examination on seven-field stereoscopic retinal photography. Three adolescents required laser photocoagulation therapy. Two adolescents were diagnosed with retinopathy following improvement in diabetes control after being lost to medical follow-up and their retinopathy improved with improved glycaemic control. Thus, we support repeated retinal screening in adolescents with diabetes duration >10 years with suboptimal glycaemic control, even when initial retinal examination is normal, as retinopathy can progress rapidly during adolescence.

中文翻译：

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九名患有早发性 1 型糖尿病的青少年的威胁视力的视网膜病变

在成人中，与糖尿病管理改善相关的糖尿病视网膜病变 (DR) 发病率有所下降。关于青少年发生严重 DR 的数据很少。在我们建立的糖尿病并发症评估服务中，我们在 2017 年至 2021 年期间记录了 9 例威胁视力的 15-17.9 岁青年视网膜病变。确定了增殖性视网膜病变和临床上显着的黄斑水肿。受试者在 10 岁之前被诊断出患有 1 型糖尿病，并且有血糖控制不佳的病史（HbA1c 86-130 mmol/mol，10%–15%）。5 例视网膜病变在 2.5 年内迅速发展，此前在 7 视野立体视网膜摄影上进行的视网膜检查正常。三名青少年需要激光光凝治疗。两名青少年在失去医疗随访后糖尿病控制得到改善后被诊断出患有视网膜病变，并且他们的视网膜病变随着血糖控制的改善而得到改善。因此，我们支持对糖尿病病程 > 10 年且血糖控制不佳的青少年重复进行视网膜筛查，即使初始视网膜检查正常，因为视网膜病变在青春期会迅速进展。