Screening for diabetic retinopathy with fluorescein angiography in patients with type 1 diabetes from adolescence to adult life. A retrospective study of the past 30 years of clinical practice in a tertiary Belgian centre

Abstract

Abstract Background The aim of the present study was to describe the prevalence and progression of DR diagnosed by fluorescein angiography (FA) in patients with type 1 diabetes (T1D) during a 30‐year follow‐up, and the relationship with glycated haemoglobin (HbA1c). Materials and methods We included 4325 FA reports representing 851 patients with T1D with a mean age at diagnosis of 10.4 years (range: 0.0–49.9) and followed between 1986 and 2015. Clinical characteristics of the population were collected from patients’ files. The HbA1c level was measured within a maximum period of ±1 year from the date of FA. Descriptive statistics were realized to study prevalence and progression of DR. Results At diagnosis of incipient abnormalities, mean age was 22.8 years (range 13.7–46.9) and mean diabetes duration was 13 years (range: 4.3–29.6). Lesions requiring treatment were observed in 5.9% of the patients at a mean age of 32.4 years (range: 30.4–34.3) and a mean diabetes duration of 23.8 years (range: 19.4–28.1). On average, it took 12.9 years (range: 12.2–13.5) to progress from an incipient abnormality to a lesion requiring treatment. Mean HbA1c ± SD was 7.8 ± 1.5% over a period of 30 years. Conclusions While it could have been expected to observe a higher prevalence of DR, our study described by far the lowest results of prevalence comparing to similar studies, probably due to a good average HbA1c over 30 years.

Keywords

• adolescent
• child
• diabetic retinopathy
• fluorescein angiography
• type 1 diabetes