Abstract

Aim To assess the retinal and choroidal thickness and ganglion cell complex (GCC) in pubescent children with type 1 diabetes (T1D) without diabetic retinopathy (DR), using spectral domain optical coherence tomography (SD-OCT). Materials and Method Sixty-four right eyes of 64 subjects with T1D and 45 right eyes of 45 age-matched healthy volunteers (control group) were enrolled in this study. The mean age of the subjects and controls was 15.3 (±SD = 2.2) and 14.6 (±SD = 1.5), respectively. SD-OCT was performed using RTVue XR Avanti. Ganglion cell complex (GCC), GCC focal loss volume (FLV), GCC global loss volume (GLV), choroidal thickness (CT), foveal (FT) and parafoveal thickness (PFT), and foveal (FV) and parafoveal volume (PFV) data were analyzed. Results There was no significant difference between subjects and controls in the CT in the fovea and nasal, temporal, superior, and inferior quadrants of the macula. There were no significant correlations between CT, duration of diabetes, and HbA1C level (p = 0.272 and p = 0.197, resp.). GCC thickness did not differ significantly between the groups (p = 0.448), but there was a significant difference in FLV (p = 0.037). Significant differences between the groups were found in the PFT and PFV (p = 0.004 and p = 0.005, resp.). There was a significant negative correlation between PFT, PFV, and HbA1C level (p = 0.002 and p = 0.001, resp.). Conclusions Choroidal thickness remains unchanged in children with T1D. Increased GCC FLV might suggest an early alteration in neuroretinal tissue. Parafoveal retinal thickness is decreased in pubescent T1D children and correlates with HbA1C level. OCT can be considered a part of noninvasive screening in children with T1D and a tool for early detection of retinal and choroidal abnormalities. Further OCT follow-up is needed to determine whether any of the discussed OCT measurements are predictive of future DR severity.

Highlights

  • Diabetes mellitus (DM) is the third most common chronic disease in children

  • The majority of cases are type 1 diabetes (T1D), but the global obesity epidemic contributes to the increasing incidence of type 2 diabetes (T2D) in children and adolescents [1,2,3]

  • Increased ganglion cell complex (GCC) focal loss volume (FLV) might suggest an early alteration in neuroretinal tissue in these patients

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Summary

Introduction

Diabetes mellitus (DM) is the third most common chronic disease in children. The majority of cases are type 1 diabetes (T1D), but the global obesity epidemic contributes to the increasing incidence of type 2 diabetes (T2D) in children and adolescents [1,2,3]. Journal of Diabetes Research blood flow in the pathogenesis of diabetic retinopathy [7,8,9]. Macular choroidal thickness (CT) is considered a putative measure of choroidal blood flow. Some researchers found decreased choroidal thickness in diabetic patients, whereas others reported increased or unchanged CT in various stages of DR [10,11,12,13,14]. The status of the choroid in patients with DM remains controversial

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