Fundoscopy was less sensitive than 7-field stereoscopic fundus photography in detecting retinopathy (0.47% vs 13.55% ). Results Among the 27 studies included in the pooled analysis (5924 unique patients age range at T2D diagnosis, 6.5-21.0 years), the global prevalence of DR in pediatric T2D was 6.99% (95% CI, 3.75%-11.00% I 2 = 95% 615 patients). The association of diabetes duration, sex, race, age, and obesity with DR prevalence was also assessed. Other outcomes included DR severity and current DR assessment methods. Main Outcomes and Measures The main outcome was the estimated pooled global prevalence of DR in pediatric T2D. The results were pooled using a random-effects model, and heterogeneity was reported using χ 2 and I 2 statistics. Two independent reviewers performed the risk of bias and level of evidence analyses. Among 1989 screened articles, 27 studies met the inclusion criteria for the pooled analysis.ĭata Extraction and Synthesis This systematic review and meta-analysis followed the Meta-analysis of Observational Studies in Epidemiology (MOOSE) and the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guidelines for systematic reviews and meta-analyses. Study Selection Three teams, each with 2 reviewers, independently screened for observational studies with 10 or more participants that reported the prevalence of DR. Search terms included diabetic retinopathy diabetes mellitus, type 2 prevalence studies and child, adolescent, teenage, youth, and pediatric. Objective To estimate the global prevalence of DR in pediatric T2D.ĭata Sources MEDLINE, Embase, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), the Cochrane Library, the Web of Science, and the gray literature (ie, literature containing information that is not available through traditional publishing and distribution channels) were searched for relevant records from the date of database inception to April 4, 2021, with updated searches conducted on May 17, 2022. This knowledge can inform retinopathy screening and treatments to preserve vision in this population. Diabetic retinopathy (DR) is a leading cause of blindness in adults with T2D however, the global burden of DR in pediatric T2D is unknown. Importance Type 2 diabetes (T2D) is increasing globally. Shared Decision Making and Communication.Scientific Discovery and the Future of Medicine.Health Care Economics, Insurance, Payment.Clinical Implications of Basic Neuroscience.Challenges in Clinical Electrocardiography.Funnel Plot Examining Publication Bias for Diabetic Retinopathy Prevalence Outcome ![]() Forest Plot Showing Mean Difference in HbA 1c in Participants With vs Without Diabetic RetinopathyĮFigure 8. Forest Plot Illustrating Prevalence of Diabetic Retinopathy in Pediatric Type 2 Diabetes by RaceĮFigure 7. Forest Plot of the Odds Ratio of Diabetic Retinopathy in Pediatric Type 2 Diabetes by SexĮFigure 6. Forest Plot of Prevalence of Diabetic Retinopathy in Pediatric Type 2 Diabetes by Diabetes Duration in All StudiesĮFigure 5. Forest Plot of Prevalence of Diabetic Retinopathy in Pediatric Type 2 Diabetes by Diabetes Duration in Retrospective Cohort StudiesĮFigure 4. Forest Plot of Prevalence of Diabetic Retinopathy in Pediatric Type 2 Diabetes by Diabetes Duration in Prospective Cohort StudiesĮFigure 3. PRISMA Flow Diagram Illustrating Study SelectionĮFigure 2. Results of Sensitivity AnalysisĮFigure 1. Risk of Bias of Included StudiesĮTable 11. ![]() Comparison of Meta-analysis Results Using Freeman-Tukey Double Arcsine Transformation and Generalized Linear Mixed-Effects Model With Confidence and Prediction IntervalsĮTable 10. Characteristics of Included StudiesĮTable 9. Type 2 Diabetes Criteria Used Across the Included StudiesĮTable 8. Search Strategy-Web of Science: Conference Proceedings Citation Index–ScienceĮTable 7. Search Strategy-Cochrane Library: Cochrane Central Register of Controlled Trials and Cochrane Database of Systematic ReviewsĮTable 6.
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