To the Editor.—

We read with interest the recent clinical report by Lueder et al, “Screening for Retinopathy in the Pediatric Patient With Type 1 Diabetes Mellitus.” Systematic screening for diabetic retinopathy was introduced in Iceland in 1980 and includes almost all type 1 diabetic patients in the country. The program has been very successful, and the prevalence of legal blindness (visual acuity of <0.1) has been reduced from 2.5% in 1980 to 0.5% in 2005.2–4  Our database includes standardized charts and fundus photographs for almost the entire population of patients with type 1 diabetes, in most cases updated annually or biannually over the 25-year period.

We examined the prevalence of diabetic retinopathy in children with type 1 diabetes mellitus. At the time of the study in 1992, 46 diabetic patients in Iceland (population: 290000) were <15 years of age, and none had diabetic retinopathy....

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