Journal articles on the topic 'Loss (Psychology) in adolescence – Juvenile literature'

Firesetting by juveniles results in billions of dollars of property loss, thousands of burn injuries, and hundreds of deaths each year. A review that specifically focuses on adolescents’ role in this devastating and costly behavior is not available. To address this gap, the current article reviews the past 30+ years of literature on adolescent firesetters, examining topics such as models of firesetting behavior, risk factors and correlates of adolescent firesetting, diagnostic issues, assessment tools and approaches, and current interventions. The article concludes with a discussion of goals for the field, including the development of relevant criteria for pathological firesetting.

AbstractAddressing a gap in the extant literature on single-parent families and juvenile delinquency, we distinguish between different types of single-parent families. Using Dutch population register data on nearly 1.3 million children, we performed logistic regressions to assess the relation between growing up in a single-parent family before age 12 and the likelihood to engage in juvenile delinquency during adolescence. Our findings suggest that the likelihood of juvenile delinquency increases (1) when children are born to a single parent, followed by children with separated parents and children experiencing parental death, compared to children growing up with both biological parents; (2) when the single-parent family started at a younger age; and (3) when children grow up with only a biological mother, for both sons and daughters, compared to only a biological father. The relationship between growing up in single-parent families and juvenile delinquency is much more complex than often assumed. Future research should pay more attention to diversity in the composition of single-parent families.

Previous research has linked changes in family structure (especially parental divorce) with involvement in juvenile delinquency. Comparatively less research has attempted to examine the long-term impact of shifts in family structure on delinquent and criminal involvement. The current study addresses this gap in the literature by examining the influence of changes in family structure during adolescence on delinquent involvement both cross sectionally and longitudinally. Our findings revealed a small and only temporary association between changes in family structure and adolescent delinquency. We discuss the implications of these results for future research.

AbstractThis study examines the intergenerational effects of caregivers' unresolved loss and abuse on children's behavior problems from middle childhood to early adolescence in an economically disadvantaged sample. One hundred twenty-four caregivers completed the Adult Attachment Interbiew (AAI) and a lifetime trauma interview during the age 13 wave of the study. Child behavior problems were assessed at four time points (ages 6, 8, 10, and 13) with teacher-reported Child Behavior Checklist total problem scales. The children of insecure caregivers with unresolved loss showed a consistent pattern of increased behavior problems from middle childhood to early adolescence. Caregivers' AAI status accounted for more variance in child behavior problems than did an alternative model of caregiver psychopathology (depression and dissociation). The results extend the literature on the effects of caregiver unresolved states of mind beyond infancy to older children and adolescents.

YA novels increasingly tell stories about memory loss, from adolescent amnesia to cognitive decline in older age. This article examines the representation of forgetting in Jenny Downham's Unbecoming, Clare Furniss's How Not to Disappear, and Emily Barr's The One Memory of Flora Banks. Drawing on liberatory psychology, queer phenomenology, and theories of creative embodiment, it argues that dominant narratives of dementia and ageing might be challenged by analysing symbolic scenes of floating and falling.

The number of overweight adolescents aged 12–19 has tripled during the past 2 decades. Although health risks associated with obesity in adolescence and adulthood are well documented in the literature, little is known about the efficacy of interventions to reduce health risks of this group. The purpose of this study was to conduct a systematic review to describe the scope, domain, and effectiveness of weight loss interventions with overweight adolescents. English-language journal articles published in nursing, psychology, nutrition, medicine, and exercise physiology literature between 1980 and 2003 were retrieved. Seventeen studies using comparison or control groups and interventions directed at reductions in adolescent body mass index or body weight were identified. Descriptive findings of those studies are reported here. Five specific limitations of these studies emerged from the analysis of the interventions: the study findings have not been validated by replication, the samples failed to include adequate representation of Latino and African American male participants, family participation in studies has been inconsistent and infrequent, there is a need for attention to study dropout rates (with attrition reported as high as 45%), and there is a need for conceptual frameworks to guide the studies.

The majority of investigations in the literature have concluded that body image is a relatively fixed phenomenon, the juvenile onset of obesity often being associated with a body image distortion which is presumed to be especially impervious to change (Stunkard and Burt, 1967; Hirsch, 1972). Nevertheless, the evidence for this suggestion is not conclusive (Collins et al., 1983), and is challenged by the findings of the present study. When subjected to regular videofeedback over a period of approximately four months, one group of obese subjects successfully lost weight, and appeared to improve the accuracy of their body image estimates. Another group of obese subjects who underwent a behaviour modification programme over the same period also lost weight and showed a lessening of body image distortion at the end of this intervention, but the changes observed between assessments were much greater for the video group. Some individuals in both treatment conditions had experienced juvenile-onset obesity. The fact that those who received videofeedback also showed improvement in terms of body image assessment and weight loss lends added support to the suggestion that the experience of videofeedback is therapeutic for the obese.

To implement effective diversion programs and determine for a well-suited intervention strategy, ascertaining who, among the adjudicated youth, is more likely to involve in multiple offending, rather than desisting after an initial delinquent behavior, is of great significance. The overall objective of this study, therefore, is to contribute to the existing knowledge on assessing the risks for multiple offending during juvenile adjudication processes. In this regard, this study examined the predicting powers of several individual-level and family-level risk factors on multiple offending during adolescence, based on a data set derived from court-ordered social examination reports (SERs) on 400 adjudicated youth in Turkey. Two binomial regression models were implemented to test the predictor values of various risk factors from these two domains. Results indicated the following as significant predictors of multiple offending among the subjects: younger age of onset in delinquency, dropping out of school, having delinquent/drug abusing (risky) friends, being not able to share problems with the family, increased number of siblings, and having a domestically migrated family. Conclusively, these findings were compared with the existing literature, and the policy implications and recommendations for future research were discussed.

The prevalence of atopic dermatitis (AD), spanning across from childhood through adolescence is increasing in the Middle East region. Poor Quality of Life (QoL), excessive healthcare expenditure, loss of school and workdays are considered to be the significant burden of AD. Although, QoL data is available for children affected by AD in Saudi Arabia, there is limited data for adolescents and adults. Moreover, data on healthcare resource utilization (HCRU) in Saudi Arabia is lacking. The purpose of this review was to evaluate the association between AD severity and AD-related QoL and HCRU in adolescents and adults in Saudi Arabia. It also aimed to identify the gaps in literature on AD in the above two patient populations in Saudi Arabia and provide recommendations for better management of QoL and HCRU- related issues. Extensive literature search was carried out through various search engines, such as PubMed, MEDLINE, Web of Science, and Google Scholar using different keywords. This review highlighted the lack of literature from Saudi Arabia with respect to the effect of AD on QoL and HCRU in adult and adolescent populations. The gaps in data regarding patient perception, physician knowledge, family and caregiver burden, and QoL for better AD management related HRQoL and HCRU in Saudi Arabia were also identified and recommendations to bridge these gaps were provided.

Objective:Norrie disease is a rare, x-linked recessive genetic disorder associated with an NDP gene mutation. Males are predominantly affected. Typical symptoms include vision loss around the time of birth and progressive hearing loss. Cognitive and behavioral abnormalities also occur in 30-50% of individuals, including developmental delays, intellectual disability, cognitive regression, psychosis, and aggression. There is limited research, however, examining the neuropsychological deficits in adulthood resulting from Norrie disease, especially with neuropsychological data and in individuals without other neurological manifestations of the disease, such as seizures. Here, we present the neurocognitive profile of a patient with Norrie disease who presented for a cognitive evaluation in adulthood due to report of more recent memory decline.Participants and Methods:Mr. Smith is a Caucasian male in his mid-40's who previously underwent genetic testing and was subsequently diagnosed with Norrie disease. As a result of his diagnosis, he experienced complete vision loss since birth and bilateral hearing loss that began in childhood and gradually worsened in adolescence. Medical history was otherwise unremarkable. Developmental milestones were met on time. Historical intelligence testing conducted in elementary school revealed borderline on one intelligence test to high average performance on other intelligence tests. However, he was retained grades several times due to factors such as behavioral disruptions and academic difficulties. He had been employed as an assembly line worker for many years, but had not worked for 10 years prior to the neuropsychological evaluation. Emotionally, he had a longstanding history of anxiety and endorsed mild anxiety and depression at the time of the evaluation. The patient first noticed memory difficulties in adolescence then noticed further decline four years prior to the neuropsychological evaluation (around when he received a left-ear cochlear implant), which had remained stable since onset.Results:In the context of low average premorbid intellectual functioning, Mr. Smith's neurocognitive profile was notable for difficulties with alphanumeric set-shifting and abstract thinking, with otherwise preserved cognitive functioning. Weaknesses observed on testing may have represented longstanding weaknesses and did not rise to the level of a cognitive disorder. Affective distress was also suspected to have accounted for some of the cognitive lapses the patient reported experiencing with day-to-day functioning.Conclusions:The current poster aims to contribute to the limited body of literature examining neuropsychological deficits in adulthood resulting from Norrie disease. This is especially critical given that the long-term cognitive dysfunction of this disorder is relatively unknown and could negatively impact patients' quality of life over time.

<b><i>Background:</i></b> Adolescence is accompanied by a variety of changes in young breast development, which greatly affects the adolescent’s psychology and socialization. <b><i>Summary:</i></b> PubMed, EMBASE, and the Cochrane Library were searched for studies relative to epidemiology, clinical characteristics, diagnosis, and management of all breast disorders in adolescence and their consequences. Development disorders are breast asymmetry, breast atrophy, breast hypoplasia, hypomastia, juvenile breast hypertrophy, and tuberous breast. Breast congenital abnormalities include athelia, amastia, accessory breast tissue, polymastia, polythelia, and congenital disorders of nipples. Breast infections are commonly caused from Gram-positive coccus rather than Gram-negative bacteria. Breast abscess occurs when breast infections are not promptly treated. Nipple discharge is caused by a variety of conditions and should be managed carefully. Fibrocystic changes, cysts, and fibroadenomas are the most common benign masses in adolescence. Primary, secondary, or metastatic breast cancer is extremely rare in adolescence. However, clinicians should include breast cancer in the differential diagnosis of a breast mass in adolescence. <b><i>Key Messages:</i></b> Clinicians should be aware of all breast disorders that may occur in adolescence. Early diagnosis and treatment will result in the reassurance of adolescents and their families without any detrimental effect on their psychology, sexual behavior, and socialization. Adolescents with breast disorders may require a multidisciplinary approach by a pediatrician, a gynecologist specializing in pediatric-adolescent gynecology, a plastic surgeon, and a psychologist for the best management of breast disorders.

The majority of youth in the juvenile justice system have experienced multiple traumatic events in their lives, including community violence, physical abuse, neglect, and traumatic loss. These high prevalence rates, coupled with the known negative consequences of trauma in childhood and adolescence, have led to a greater emphasis on implementing trauma-informed services and practices within juvenile justice settings. However, although many stakeholders and government entities have expressed support for creating more trauma-informed juvenile justice systems, there is still limited empirical knowledge about which interventions are most effective at improving outcomes, particularly at the organizational or facility level. In an effort to fill this gap, the current study evaluated the impact of a trauma-informed milieu intervention, including skills training for youth and training for staff, on rates of violence at two secure juvenile detention facilities ( N = 14,856) located in a large Northeastern city. The analyses revealed that the intervention was significantly related to a reduction of violent incidents in Facility A, with no impact on incidents in Facility B. Follow-up analyses revealed that a larger proportion of eligible youth in Facility A completed the skills group program as compared with eligible youth in Facility B (16% vs. 9%). This finding has important implications for the implementation of trauma-informed interventions for youth in juvenile detention settings, as it suggests that to impact outcomes at the facility level, a minimum threshold of youth may need to be exposed to the intervention. In addition, reductions in violence at Facility A were only realized after both staff training and youth skills components were implemented, suggesting that both components are necessary to create change at the facility level. Future research is needed to further explore the impact of organizational and implementation-level factors on trauma-informed care outcomes in juvenile justice settings.

AbstractPhelan-McDermid syndrome (PMS) is caused by haploinsufficiency of the SHANK3 gene on chromosome 22q13.33 and is characterized by intellectual disability, hypotonia, severe speech impairments, and autism spectrum disorder. Emerging evidence indicates that there are changes over time in the phenotype observed in individuals with PMS, including severe neuropsychiatric symptoms and loss of skills occurring in adolescence and adulthood. To gain further insight into these phenomena and to better understand the long-term course of the disorder, we conducted a systematic literature review and identified 56 PMS cases showing signs of behavioral and neurologic decompensation in adolescence or adulthood (30 females, 25 males, 1 gender unknown). Clinical presentations included features of bipolar disorder, catatonia, psychosis, and loss of skills, occurring at a mean age of 20 years. There were no apparent sex differences in the rates of these disorders except for catatonia, which appeared to be more frequent in females (13 females, 3 males). Reports of individuals with point mutations in SHANK3 exhibiting neuropsychiatric decompensation and loss of skills demonstrate that loss of one copy of SHANK3 is sufficient to cause these manifestations. In the majority of cases, no apparent cause could be identified; in others, symptoms appeared after acute events, such as infections, prolonged or particularly intense seizures, or changes in the individual’s environment. Several individuals had a progressive neurological deterioration, including one with juvenile onset metachromatic leukodystrophy, a severe demyelinating disorder caused by recessive mutations in the ARSA gene in 22q13.33. These reports provide insights into treatment options that have proven helpful in some cases, and are reviewed herein. Our survey highlights how little is currently known about neuropsychiatric presentations and loss of skills in PMS and underscores the importance of studying the natural history in individuals with PMS, including both cross-sectional and long-term longitudinal analyses. Clearer delineation of these neuropsychiatric symptoms will contribute to their recognition and prompt management and will also help uncover the underlying biological mechanisms, potentially leading to improved interventions.

Abstract Background: This research adds to scarce literature regarding adolescent experiences of traumatic brain injury (TBI). Retrospective accounts of young adults who had sustained a TBI in adolescence were analysed to explore the perceived impact this had on their lives and forming identities during this important developmental stage. Methods: Thirteen adults (aged 20–25 years; mean 23 years) who sustained a mild or moderate TBI during adolescence (i.e. aged 13–17 years at injury), approximately 7.7 years (range = 6.7–8.0 years) prior, participated in the research. Semi-structured individual interviews, analysed using thematic analysis, explored participants’ experiences following their TBIs. Results: Thematic analysis of interview data produced two categories of themes: (1) Impacts on Important Areas of Life, which included: schoolwork suffered, career opportunities became limited, struggling with work and missing out socially; and (2) Impacts on Identity: with themes including feeling ‘stupid’, feeling self-conscious, loss of social identity and being dependent. Conclusions: TBI sustained during adolescence can have broad impacts on important areas of life and on developing identity.

Anorexia nervosa is one of the most debilitating mental illnesses that emerges during adolescence, especially among females. Anorexia nervosa is characterized by severe voluntary food restriction and compulsive exercising, which combine to cause extreme body weight loss. We use activity-based anorexia (ABA), an animal model, to investigate the neurobiological bases of vulnerability to anorexia nervosa. This is a Mini-Review, focused on new ideas that have emerged based on recent findings from the Aoki Lab. Our findings point to the cellular and molecular underpinnings of three ABA phenomena: (1) age-dependence of ABA vulnerability; (2) individual differences in the persistence of ABA vulnerability during adolescence; (3) GABAergic synaptic plasticity in the hippocampus and the prefrontal cortex that contributes to the suppression of the maladaptive anorexia-like behaviors. We also include new data on the contribution to ABA vulnerability by cell type-specific knockdown of a GABA receptor subunit, α4, in dorsal hippocampus. Although the GABA system recurs as a key player in the gain of ABA resilience, the data predict why targeting the GABA system, singularly, may have only limited efficacy in treating anorexia nervosa. This is because boosting the GABAergic system may suppress the maladaptive behavior of over-exercising but could also suppress food consumption. We hypothesize that a sub-anesthetic dose of ketamine may be the magic bullet, since a single injection of this drug to mid-adolescent female mice undergoing ABA induction enhances food consumption and reduces wheel running, thereby reducing body weight loss through plasticity at excitatory synaptic inputs to both excitatory and inhibitory neurons. The same treatment is not as efficacious during late adolescence but multiple dosing of ketamine can suppress ABA vulnerability partially. This caveat underscores the importance of conducting behavioral, synaptic and molecular analyses across multiple time points spanning the developmental stage of adolescence and into adulthood. Since this is a Mini-Review, we recommend additional literature for readers seeking more comprehensive reviews on these subjects.

AbstractThis study seeks to examine water as a liminal symbol that reflects and symbolizes the liminal identities of adolescents and young adults in two selected plays for young adults: Feeding the Moonfish (2011) by Barbara Wiechmann and Our Place (2015) by Terry Gabbard. Feeding the Moonfish deals with the young adults Martin and Eden who suffer from traumatic experiences. They go to the dock by the lake to rediscover themselves, and, eventually, heal by the water. In a similar setting, Our Place comprises five stories that revolve around adolescents and young adults’ feelings of loss, fragmentation, frustration, love, and death. In both plays, the characters go through the three stages of liminality defined by Arnold van Gennep: the pre-liminal, the liminal, and the post-liminal and, finally, emerge as reborn/healed. Water is a complex liminal symbol that reflects the experiences of adolescence and young adults, and combines contradictory meanings which are essential, expressive, and, most importantly, complementary for the development of the characters and for their eventual recovery. Using the concept of liminality and adolescent psychology to read scenes in which liminal experiences (confusion, indecisiveness, and disorientation) are present, this study argues that the depiction of liminal experiences near water in these plays for young adults offers complex symbols for the study of young adulthood and for encountering and responding to traumas experienced in adolescence.

Background and aims: The needs of autistic individuals and their families are unique in each developmental phase, but this diversity is more palpable during adolescence. Literature generally presents a view that caregivers experience challenges in caring for autistic children, especially in low- and middle-income countries, where formal support services are uneven or unavailable. The present study explored the lived experiences of parents of autistic adolescents in the Indian context. Methods: In-depth interviews with 12 parents were analyzed using an interpretative phenomenological approach. Results: Three superordinate themes were derived: (a) Acceptance alongside recurring experiences of grief and loss, (b) post-traumatic growth and vicarious transformation, and (c) What after me? Planning for future care services with limited systemic support. Beginning with the initial recognition and diagnosis of autism spectrum disorder, parents progressed through a series of experiences that strengthened and challenged their understanding and aided in their acceptance. Parents recognize their adolescents’ key attributes, growth, development, and persisting differences that could contribute to future challenges. Grief experiences, however, sporadic, persisted alongside acceptance. Conclusion: Despite challenges, families were adapting to the changing needs of the developmental phases in unique ways, with or without formal support available to them. Nonetheless, there is a considerable need to address the existing gaps and felt needs of parents, focusing on empowering parents and capacity building toward providing comprehensive services to autistic individuals with a lifespan approach.

AbstractThe extant literature has clearly demonstrated that transgender and nonbinary adolescents (TNBA) face extreme stress related to navigating gender identity and expression across various social environments. Additionally, parents are perhaps the most critical aspect of support for TNBA, and research has repeatedly identified the benefits of parent support for adolescent mental health. However, few studies underscore how TNBA and parents within the same family perceive parent support after adolescents disclose that they are transgender or nonbinary. The present qualitative study uses a life history calendar (LHC) interview approach with 20 TNBA-parent dyads (40 individual interviews) to explore TNBA-parent perceptions of parent support and adjustment related to TNBA gender identity and affirmation. Findings yielded three main points regarding parental support for TNBA. First, the time between disclosure to a parent and puberty mattered for parental support and adjustment processes. Second, parents who stepped into their child’s gender journey during their child’s adolescence grappled with feelings of grief and loss as they were making decisions to support their child’s gender affirmation. For many of these families, stigma-related fears and adolescent distress impacted parent support for their child’s gender journey. Third, parents lacked a familiar and affirming roadmap in their own families and communities, and although parents connected with other parents of trans kids for support, for some, these supportive resources presented challenges. Continued research can further study the complex drivers of support and the potential impact of these support processes on adolescent and parental well-being.

Abstract Case report - Introduction Dermatomyositis (DM) is a multisystem, autoimmune condition. It belongs to a spectrum of idiopathic inflammatory myopathies (IIMs) which can present with proximal muscle weakness or cutaneous lesions, but can also cause systemic disease including interstitial pneumonia, myocarditis, and inflammatory arthritis. Retinal involvement is not widely described. However, we present three cases with visual disturbance caused by retinal pathology – two of retinal vein occlusion, and one of retinal vasculitis. Two cases have anti-melanoma differentiation-associated gene 5 (anti-MDA-5), which may be a pathophysiological link to retinal microvascular damage. Case report - Case description Patient 1: A 43-year-old female with Anti-NXP-2 juvenile DM presented with bilateral visual loss. She was diagnosed with DM aged 6 when she presented with calcinosis, weakness, inflammatory arthritis and rash. Though disease was most active during adolescence, she has ongoing problematic calcinosis. ESR remains 26mm/hr. Fundoscopy showed scattered haemorrhages and macular oedema with no features of retinal vasculitis. Thrombophilia screens including antiphospholipid were negative. Bilateral branch retinal vein occlusions were treated with anti-VEGF injections. Post-treatment visual acuity is 6/6. Patient 2: A 46-year-old female with Anti-MDA-5 DM presented with monocular reduced visual acuity. She was diagnosed with a hemi-retinal vein occlusion. Thrombophilia screen showed she was antiphospholipid negative, but a heterozygote carrier of Factor V Leiden. She had moderately active disease at the time with evidence of organising pneumonia, and active Gottron’s papules. Prednisolone was increased, tacrolimus dosing was optimised and clopidogrel commenced. Later that year she was given rituximab for her organising pneumonia to which her skin showed good response. However, 8 months later she had a further central retinal vein occlusion with macular oedema treated with Anti-VEGF injections. Her subsequent visual acuity is 6/6. Patient 3: A 36-year-old male with Anti-MDA-5 DM with skin, joint and lung involvement was initially treated with IV cyclophosphamide. He then developed severe Raynaud’s, perniotic skin rash and vasculitic digital ulceration. He noted reduction in visual acuity. Fundoscopy revealed bilateral cotton wool spots and wide-field fundus fluorescein angiography showed microaneurysms. A diagnosis of a mild retinal vasculitis was made. He was admitted for epoprostenol, rituximab and 50mg prednisolone. Antiphopsholipid screen was negative. Vasculitic lesions on his fingers improved, and retinal abnormalities resolved. He has been on low-dose prednisolone without additional DMARDS for several years, with no recurrence of retinal disease in 10 years and skin has stabilised. Case report - Discussion Retinal vein occlusion (RVO) is the second most common retinal vascular disease; it typically causes painless visual loss in older people above the age of 60. Obstruction of the retinal venous system is caused by thrombus, compression by an adjacent retinal artery or disease within the vein such as vasculitis. This leads to retinal ischaemia and elevated retinal vascular endothelial growth factor (VEGF) levels. VEGF increases the vascular permeability contributing to macular oedema. Vision loss occurs secondary to macular oedema or ischaemia. Treatment is with anti-VEGF injections and risk factor modification. There is an association with thrombophillic disorders including antiphospholipid syndrome and hyperhomocysteinemia. Additional risk factors include increasing age, hypertension, hyperlipidaemia, glaucoma and diabetes. Cases of RVO have been described in dermatomyositis and other systemic autoimmune diseases. The exact mechanism is not fully understood but may be due to vasculopathy or microvascular damage. Our cases were all under the age of 60 with no significant risk factors other than patient 2’s history of heterozygotic factor V Leiden, which only slightly increases the risk of blood clots. The simultaneously active inflammatory disease at the time and recurrent thrombosis whilst on clopidogrel adds suspicion of a vasculopathic component. All cases were anti-phospholipid negative. Anti-MDA-5 disease is associated with complement-mediated microvascular damage leading to striking mucocutaneous manifestations. Lesional biopsies have demonstrated occlusive small and medium vessel vasculopathy with a type-1-interferon signature. Anti-NXP-2 has also been linked to GI-tract vasculitis and perforation in a JDM case series. It is plausible similar damage has occurred in the retinal vasculature of our cases. Active inflammation in the venules is classically seen in Behcet’s disease, but not typical of other connective tissue disease. Rather than a vasculitis, the two RVO cases may reflect a vasculopathy due to endothelial activation. Case report - Key learning points The inflammatory process in DM can cause microangiopathic damage. This is evident in the skin lesions of MDA-5-positive disease, and is also postulated to be the pathophysiology behind complications such as rapidly progressive interstitial lung disease, which is most common for patients with anti-MDA-5 disease and carries a high mortality. A case series of GI perforation in NXP-2-positive JDM suggest that microangiopathy may be a feature of anti-NXP-2 disease also. Retinal involvement in DM is rare, but there have been a few reports in the literature. Retinal vasculitis can also be caused by other systemic inflammatory diseases including Behcet’s, SLE, granulomatosus polyangiitis, sarcoidosis and multiple sclerosis. Differentials include ocular inflammatory disease (e.g., pars planitis), infectious disease (e.g., toxoplasmosis, cytomegalovirus, herpes simplex virus) or malignancy. Retinopathy associated with DM usually completely resolves without complications but if left untreated, profound visual loss may result from macular haemorrhage or macular oedema leading to central scotomas. Potentially, a vasculopathic process with endothelial activation has propagated retinal vein occlusions in two of our cases. RVO can lead to permanent visual loss. Early identification and treatment with anti-VEGF injections or immunosuppressants has prevented visual loss in our three patients. It remains unknown whether escalating immunosuppression in the two cases of RVO would reduce chances of recurrence. RVO is not in itself a rare disease, and it remains possible that simultaneous diagnoses with DM could be coincidental rather than pathologically directly linked, though the young age of all affected patients would be atypical. Traditional modifiable risk factors such as diabetes, hypertension and hyperlipidaemia should always be excluded and managed first. It is important to be aware that patients with DM and other idiopathic inflammatory myopathies may be at increased risk of retinal complications and any new visual symptoms should be investigated appropriately.