Background: Recognised complications of cystic fibrosis diabetes (CFD) include Retinopathy, nephropathy, and neuropathy (Sandouk, Z et al. J Clin Transl Endocrinol 2021; 26:100278). Guidance produced by the Cystic Fibrosis Trust recommends annual retinal screening for all diabetic patients over the age of twelve years (Cystic Fibrosis Trust. Management of cystic fibrosis diabetes 2022).
Aim: To determine uptake of annual retinopathy screening, predictors of retinopathy, and prevalence of retinopathy in an adult population with CFD.
Method: A retrospective review of cystic fibrosis (CF) patients with CFD was performed. Data collected included age, sex, forced expiratory volume (FEV1), body mass index (BMI), HbA1c, treatment with insulin or oral antidiabetics or diet, attendance at retinopathy screening, and presence of microvascular complications at annual reviews between September 2022 and September 2023.
Results: 77 of 112 (68.8%) of those with CFD attended retinal screening. Of the 77 who underwent screening 15 (19.5%) had evidence of retinopathy. 11 out of 15 (73.3%) of those with retinopathy were on insulin, the remaining 4 patients (26.7%) were taking oral antidiabetics. No significant difference in age, FEV1, BMI, HbA1c or duration of diabetes was seen between those with or without retinopathy.
Conclusion: Approximately one fifth of patients screened had evidence of retinopathy but close to one third of patients with CFD did not attend yearly screening appointments. With advancements in the management of CF there is an ever-aging CF population, which highlights the increasing importance of improving uptake of yearly retinal screening.