The Relationship of Puberty to Diabetic Retinopathy

Murphy, Robert P.; Nanda, Mohit; Plotnick, Leslie P.; Enger, Cheryl; Vitale, Susan; Patz, Arnall

doi:10.1001/archopht.1990.01070040067032

Cited by 74 publications

(26 citation statements)

References 10 publications

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“…Proliferative retinopathy is rare but may occur in patients Ͻ20 years of age (173). In one study, the relative risk of retinopathy in a pubertal versus prepubertal child was 4.8 (175). Hypertension (179,180), poor metabolic control (44 -48,49,182), presence of albuminuria, hyperlipidemia, smoking (183), duration of diabetes (172), and pregnancy all confer increased risk of developing retinopathy (184).…”

Section: Retinopathycontrasting

confidence: 40%

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Care of Children and Adolescents With Type 1 Diabetes

Klingensmith²,

et al. 2005

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Section: Retinopathycontrasting

confidence: 40%

“…Although retinopathy is most commonly described after the onset of puberty, retinopathy can occur in prepubertal children (175). Pre-DCCT epidemiological data suggest that background retinopathy is present in 34 -42% of adolescents (176) and in 9% of children Ͻ13 years (177).…”

Section: Retinopathysupporting

confidence: 39%

Care of Children and Adolescents With Type 1 Diabetes

Klingensmith²,

et al. 2005

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“…However, it is well-known that pubertal development is dependent on nutritional status, sex, hereditary factors and ethnicity [16]. Murphy et al [17] and Rogers et al [18] demonstrated retinopathy Comparison between patients with and without retinopathy using Wilcoxon non-parametrical test, chi-square-test or Fisher's exact test [17] demonstrated that the adolescents in Tanner stage 5 had significantly higher mean HbA 1 c . We also found a higher prevalence of retinopathy in pubertal stage 5 than in pubertal stage 1, but not that pubertal development reduced the survival time without retinopathy.…”

Section: Discussionmentioning

confidence: 46%

Prevalence of diabetic retinopathy in children and adolescents with IDDM

et al. 1997

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Summary Vision-threatening diabetic retinopathy can be prevented if it is diagnosed before becoming too advanced. Since diabetic retinopathy has been reported to occur only rarely before the end of pubertal development, children and adolescents are seldom included in screening programmes. We invited 780 children and adolescents with insulin-dependent diabetes mellitus diagnosed before the age of 15.0 years (disease duration of < 12 years) and who were older than 9.0 years at the time of examination from eight regions of Sweden. Retinal examination was performed with stereoscopic fundus photograph. The photograph were rated according to a modified Airlie House classification. The dropouts (223/780, 28.6 %) were significantly older and with a longer duration of diabetes than the examined children (p < 0.001 and 0.001, respectively). Photographs from 557 patients aged (median [interquartile range]:14.6 [12.4-17.0]) years and with a diabetes duration of 8.0 (5.5-9.9) years were evaluated. Retinopathy was demonstrated in 81 patients (14.5 %):66 with background retinopathy, 2 with microaneurysms and hard exudates, 12 with preproliferative retinopathy, 1 with proliferative retinopathy. Preproliferative retinopathy was diagnosed in a 12.8-year-old girl in pubertal stage 3 and an 11.8-year-old boy in pubertal stage 2, and proliferative retinopathy was found in a 21.5-year-old girl. Retinopathy was demonstrated in 6 % and 18 % of patients in pubertal stages 1 and 5, respectively. The overall prevalence of retinopathy in this population may even be higher since the dropouts were older and had a longer duration of diabetes. Since background and preproliferative retinopathy were found in children before puberty, we recommend including children and adolescents in screening programmes for diabetic retinopathy from the age of 10 years. [Diabetologia (1997) 40: 307-310]

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“…In a previous prospective work, Porta et al report that onset of diabetes before puberty could be an additional risk factor to the development of proliferative retinopathy (Porta et al 2001). Knowles et al (1965) and Murphy et al (1990) proposed there was a constant interval from the time of the adolescent growth spurt to the development of retinopathy and the years before this growth spurt were not an important consideration in the development of retinopathy. Further, Klein et al (1985) found in a southern Wisconsin population-based study that the presence of retinopathy was more strongly associated with the duration of a patient's diabetes after the age of 13 than before it.…”

Section: Pubertymentioning

confidence: 39%