Global Prevalence of Diabetic Retinopathy in Pediatric Type 2 Diabetes: A Systematic Review and Meta-analysis
Authors' conclusion
In this study, DR prevalence in pediatric T2D increased significantly at more than 5 years after diagnosis. These findings suggest that retinal microvasculature is an early target of T2D in children and adolescents, and annual screening with fundus photography beginning at diagnosis offers the best assessment method for early detection of DR in pediatric patients.
Study context
- Population
- Pediatric T2D (age range at T2D diagnosis 6.5–21.0 years); observational studies with ≥10 participants reporting diabetic retinopathy (DR) prevalence
- Participants
- 5,924 participants27 studies
- Outcome
- Estimated pooled global prevalence of DR in pediatric T2D
Methodological detailsrandom-effects model, MOOSE and PRISMA reporting guidelines, Heterogeneity was high among studies
- Random-effects model
- MOOSE and PRISMA reporting guidelines
- Heterogeneity was high among studies
Pooled result
As reported in the abstract
Global prevalence of DR in pediatric T2D
Pooled global prevalence of DR
6.99%
95% CI 3.75%–11.00%; I2 = 95%; 615 patients
Further pooled results
| Outcome | Values |
|---|---|
| DR detection by assessment method | Fundoscopy 0.47% (95% CI 0%–3.30%) · I2 0% · 7-field stereoscopic fundus photography 13.55% (95% CI 5.43%–24.29%) · I2 92% |
| DR prevalence by time since T2D diagnosis | <2.5 years 1.11% (95% CI 0.04%–3.06%) · I2 5% · 2.5 to 5.0 years 9.04% (95% CI 2.24%–19.55%) · I2 88% · >5 years 28.14% (95% CI 12.84%–46.45%) · I2 96% |
DR detection by assessment method
- Fundoscopy less sensitive than 7-field stereoscopic fundus photography
DR prevalence by time since T2D diagnosis
- DR prevalence increased over time
Association of age, sex, race and obesity with DR prevalence
- DR prevalence increased with age
- No differences based on sex, race, or obesity
Original publication
Global Prevalence of Diabetic Retinopathy in Pediatric Type 2 Diabetes: A Systematic Review and Meta-analysis. JAMA Netw Open. Published 1 March 2023. doi:10.
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