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Evaluation of retinal neurovascular structures by optical coherence tomography and optical coherence tomography angiography in children and adolescents with type 1 diabetes mellitus without clinical sign of diabetic retinopathy

Graefe's Archive for Clinical and Experimental Ophthalmology volume 258, pages 2363–2372 (2020)Cite this article

Abstract

Background

The aim of the study was to investigate whether retinal neurovascular structural impairment in children and adolescents with type 1 diabetes mellitus (T1D) without clinical signs of diabetic retinopathy (DR) could be detected early via optical coherence tomography (OCT) and OCT angiography (OCTA).

Methods

In the current prospective, cross-sectional, observational clinical study children and adolescents with T1D without DR were evaluated between December 2018 and May 2019. Retinal neurovascular structures in the macular and optic disc regions were examined in detail and quantitatively assessed using OCT and OCTA. Data from subjects with T1D were compared with data from healthy controls. Whether retinal neurovascular structural changes were significantly associated with puberty stage, diabetes duration, and HbA1c level was also investigated.

Results

The T1D group included 110 eyes and the control group included 84 eyes. In the T1D group the mean inside disc vessel density (VD) was significantly lower than that of the control group (p < 0.001), as was the mean superior temporal disc VD (p < 0.043). Puberty stage was significantly associated with retinal thickness, parafoveal superficial capillary plexus VD, and peripapillary retinal nerve fiber layer thickness (p < 0.05). Diabetes duration and HbA1c level was significantly correlated with retinal layer thickness, foveal avascular zone diameter, and superficial and deep capillary plexus VDs.

Conclusion

In children and adolescents with T1D without clinical signs of DR, the VD of the disc region is affected earlier than the macular region. In these patients, early neurovascular impairment can be detected non-invasively via OCT and OCTA.

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Affiliations

  1. Department of Ophthalmology, Sisli Hamidiye Etfal Training and Research Hospital, University of Health Sciences, Halaskargazi Cad. Etfal St., 34371, Sisli/Istanbul, Turkey

    Semra Tiryaki Demir, Mehmet Egemen Karatas, Oguz Kaan Kutucu, Saniye Uke Uzun & Dilek Guven

  2. Department of Pediatric Endocrinology, Sisli Hamidiye Etfal Training and Research Hospital, University of Health Sciences, Istanbul, Turkey

    Ahmet Ucar

  3. Department of Pediatric, Sisli Hamidiye Etfal Training and Research Hospital, University of Health Sciences, Istanbul, Turkey

    Gizem Kara Elitok

  4. Department of Ophthalmology, Basaksehir Cam and Sakura City Hospital, Istanbul, Turkey

    Murat Karapapak

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  1. Semra Tiryaki Demir
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Demir, S.T., Ucar, A., Elitok, G.K. et al. Evaluation of retinal neurovascular structures by optical coherence tomography and optical coherence tomography angiography in children and adolescents with type 1 diabetes mellitus without clinical sign of diabetic retinopathy. Graefes Arch Clin Exp Ophthalmol 258, 2363–2372 (2020). https://doi.org/10.1007/s00417-020-04842-1

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  • DOI: https://doi.org/10.1007/s00417-020-04842-1

Keywords

  • Deep capillary plexus
  • Foveal avascular zone
  • Peripapillary retinal nerve fiber layer
  • Radial peripapillary capillary plexus
  • Superficial capillary plexus