Optical coherence tomography angiography vessel density in children with type 1 diabetes

Abstract

PurposeTo assess the optical coherence tomography angiography (OCTA) retinal vessel density and foveal avascular zone (FAZ) in children with type 1 diabetes (T1D) and compare potential pathologic early changes in this population to healthy age-matched controls.MethodsThis study included 130 pubescent children: 94 with T1D (188 eyes) and 36 of their age-matched control group (60 eyes). OCTA was performed using AngioVue (Avanti, Optivue). FAZ area (mm2) in superficial plexus, whole superficial capillary vessel density (wsVD), fovea superficial vessel density (fsVD), parafovea superficial vessel density (psVD), whole deep vessel density (wdVD), fovea deep vessel density (fdVD), parafovea deep vessel density (pdVD), foveal thickness (FT) (μm) and parafoveal thickness (PFT) (μm) were taken into analysis. Among the studied patients with T1D there were assessed codependences regarding the investigated foveal and parafoveal parameters and selected potential predictors, i.e. patient’s age (years), diabetes duration time (years), age of onset of the disease (years), mean level of glycated hemoglobin (HbA1C) (%), and concentration of serum creatinine (mg/dL).ResultsNone of the abovementioned OCT and OCTA parameters was statistically significantly different between the groups. The patient’s age statistically significantly did not influent any of the OCT and OCTA parameters. Yet an elevated level of HbA1C tended to reduce the parafovea superficial vessel density (p = 0.039), and parafoveal thickness (p = 0.003) and an increased serum creatinine level correlated with the decreased whole deep vessel density (p < 0.001). The parafovea deep vessel density in the diabetic patients decreased when the serum creatinine level (p = 0.008), age of onset of the disease (p = 0.028), and diabetes duration time (p = 0.014) rose.ConclusionsVessel density, both in superficial and deep plexuses, and FAZ area are normal in pubescent children with T1D comparing to healthy subjects. An elevated level of HbA1C correlated with reduced psVD and PFT. Longitudinal observation of these young patients is needed to determine if any of these OCTA measurements are predictive of future DR severity.

Optical Coherence Tomography Angiography in Type 1 Diabetes Mellitus. Report 1: Diabetic Retinopathy

“…25 The largest series in type 1 DM have been described in children, and they interestingly have shown controversial results. [26][27][28][29][30] Golebiewska et al reported that no differences were seen in the VD or FAZ area in any of the studied plexuses between patients with type 1 DM and controls (n = 188 vs. 60); however, Niestrata-Ortiz et al described that FAZ area was different between diabetic and healthy children (n = 112 vs. 30). 27,28 In this last paper, a greater FAZ area was also associated with a longer duration of the disease.…”

Comparison of foveal avascular zone and retinal vascular density in healthy Chinese and Caucasian adults

“…A study on Caucasian children revealed that the size of the FAZ area was 0.240 ± 0.253 mm 2 (Gołębiewska et al. ). Foveal avascular zone (FAZ) was assessed in Caucasian adults by using fluorescein angiography and OCT, and it was found to be 241.0 ± 28.9 in individuals with no‐ and mild diabetic retinopathy (Dmuchowska et al.…”

Early Macular Vessel Density Loss in Acute Ischemic Optic Neuropathy Compared to Papilledema: Implications for Pathogenesis

“…Superficial retinal vasculatures (SVs) were imaged in the slab images from the inner boundary 3 μm beneath the internal limiting membrane to the outer boundary 15 μm beneath the IPL, whereas the deep retinal vasculatures (DVs) were imaged in slab images from the inner boundary 15 μm beneath the IPL to the outer boundary 70 μm beneath the IPL, according to the default setting of the manufacturer's software (Optovue, Inc.). 16 , 17 Superficial and deep retinal measurements of the vasculatures were obtained in two regions: (1) macular vessel density was calculated in a 6-mm diameter region and divided into whole macula, superior hemi-macula, and inferior hemi-macula to calculate the hemispheric measurements; (2) parafoveal vessel density was measured in an annular region with an inner diameter of 1 mm and outer diameter of 3 mm centered on the fovea, and the parafoveal region was divided into four sectors (superior, inferior, temporal, and nasal) in addition to superior and inferior hemispheric areas as shown in the Figure .…”