Evaluation of microvascular changes in retinal zones and optic disc in pediatric patients with type 1 diabetes mellitus

Kara, Özlem; Can, Mehmet Erol

doi:10.1007/s00417-020-04935-x

Cited by 8 publications

(18 citation statements)

References 30 publications

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“…Foveal density measurement is reported to be an accurate indicator in the evaluation of macular perfusion. 31,35…”

Section: Discussionmentioning

confidence: 99%

“…In many studies, the OCTA findings of healthy controls and non-DRP T1DM children 6,[31][32][33][34][35][36] and adult [37][38][39][40][41] patients have been compared, and important evidence has been found for the early diagnosis of DR. The measurement of vessel density with OCTA has been shown to be a good indicator of capillary dropout in the retina.…”

Section: Discussionmentioning

confidence: 99%

“…Foveal density measurement is reported to be an accurate indicator in the evaluation of macular perfusion. 31,35 In a few studies, vascular changes in the OD have been evaluated with OCTA parameters in T1DM patients. 31,32,48 Li et al 48 found the radial peripapillary capillary density in the whole image and peripapillary area to be lower in non-DR T2DM patients than in the control group.…”

Section: Discussionmentioning

confidence: 99%

“…31,35 In a few studies, vascular changes in the OD have been evaluated with OCTA parameters in T1DM patients. 31,32,48 Li et al 48 found the radial peripapillary capillary density in the whole image and peripapillary area to be lower in non-DR T2DM patients than in the control group. They argued that decreased optic nerve head (ONH) perfusion inside the optic disc is an important biomarker in the detection of early-stage DR, and OCTA with ONH mode could be a promising tool in DR screening.…”

Section: Discussionmentioning

confidence: 99%

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The relationship between carotid intima-media thickness and microvascular changes in retinal zones and optic disc in patients with type 1 diabetes mellitus

Ulutaş

Güçlü

Aslanci

et al. 2021

European Journal of Ophthalmology

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Purpose The aim of this study was to detect early retinal vascular changes with optical coherence tomography angiography (OCTA) in type 1 diabetes mellitus (T1DM) patients without diabetic retinopathy and to evaluate the correlation of the results with carotid intima-media thickness (IMT). Design This is a case–control and cross-sectional study. Methods This study included 38 adult patients with T1DM, and 38 age and gender-matched healthy controls. Retinal and optic disc (OD) measurements were taken using OCTA. The carotid artery IMT of each patient was measured using Doppler ultrasonography. Superficial capillary plexus (SCP) and deep capillary plexus (DCP) vessel density, foveal avascular zone (FAZ), non-flow area (NFA) and foveal density (FD) were analysed in the fovea centred 6 × 6 mm macular area. The superficial capillary plexus and DCP were also scanned centred on the peripapillary region. The correlations between OCTA measurements and carotid IMT, duration of DM and haemoglobin A1c levels in patients with T1DM were evaluated. Results The mean values for carotid IMT were significantly higher in diabetic patients than in controls ( p < 0.001). The mean values for vessel density SCP, DCP and OD were significantly lower in the diabetic group ( p < 0.05). There were correlations between the carotid IMT and duration of T1DM and the evaluated parameters of OCTA. Conclusion Microvascular changes in the SCP and DCP in patients with T1DM without DR offer important data. OCTA can be used to detect early microvascular changes in patients with T1DM without DR. In addition, a relationship was found between SCP vascular dropout and carotid IMT.

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“…Foveal density measurement is reported to be an accurate indicator in the evaluation of macular perfusion. 31,35…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

The relationship between carotid intima-media thickness and microvascular changes in retinal zones and optic disc in patients with type 1 diabetes mellitus

Ulutaş

Güçlü

Aslanci

et al. 2021

European Journal of Ophthalmology

View full text Add to dashboard Cite

show abstract

“…Such changes may indicate early microcirculatory disorders in children with type 1 diabetes, but further studies are needed to determine if the results may influence the incidence of DR in future. Kara and Can found significantly lower foveal vessel density in the group of diabetic children compared with the controls and concluded that OCTA can be used for the early detection of DR in youths [ 40 ]. Similar conclusions were made by Veiby et al, after they confirmed lower superficial and deep capillary vessel densities in 315 T1D eyes [ 41 ].…”

Section: Introductionmentioning

confidence: 99%

Diabetic Retinopathy in Children with Type 1 Diabetes—Occurrence and Screening Using Optical Coherence Tomography

Wysocka‐Mincewicz

Gołębiewska

Olechowski

et al. 2021

Life

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Purpose: To describe the occurrence of diabetic retinopathy, the principles for pediatric care of patients with diabetes, and the utility of optical coherence tomography. Pediatric patients with type 1 diabetes should be screened for diabetic retinopathy upon the lapse of 5 years following the diagnosis. The patients in the time of puberty, who should be screened promptly after the diabetes diagnosis, and patients with type 2 diabetes are the exceptions. Special attention must be paid not only to retinopathy, but also to other possible concomitant conditions, such as cataract, refractive errors, or neuropathy. New techniques, such as optical coherence tomography angiography (OCTA), may contribute greatly to the early detection of retinopathy, facilitating the decision to modify the treatment. The application of modern insulin pumps with continuous glucose monitoring systems has greatly diminished the incidence rate of early symptoms of diabetic retinopathy in the pediatric population.

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Changes in early optical coherence tomography angiography among children and adolescents with type 1 diabetes: Relation to fibroblast growth factor 21

Sherif

Matter

Salah

et al. 2023

Diabetes Metabolism Res

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Aims Current diagnostic and treatment modalities target late stages of diabetic retinopathy (DR) when retinopathy has already been established. Novel and more sensitive strategies are needed. Optical coherence tomography angiography (OCTA) permits non‐invasive visualisation of retinal microcirculation. Fibroblast growth factor‐21 (FGF21) plays an important role in glucose and lipid homoeostasis. This study assesses early OCTA changes among children and adolescents with type 1 diabetes (T1DM) compared to fundus photography and correlates them to diabetes‐duration, glycaemic control, and FGF21; hence, it determines their value in early detection of DR. Methodology Hundred children and adolescents with T1DM were assessed for diabetes‐duration, insulin therapy, hypoglycemia, and diabetic‐ketoacidosis frequency, Tanner staging, glycated‐haemoglobin (HbA1c), fasting lipids, urinary albumin/creatinine ratio, and serum FGF21. OCTA and fundus photography were done for the studied patients and 100 age, gender, and Tanner matched healthy controls. Results The mean age of the children and adolescents with T1DM was 10.84 years, their mean diabetes‐duration was 3.27 years and their median FGF21 was 150 pg/ml. FGF21 was significantly higher among children and adolescents with T1DM than controls (p < 0.001). Children and adolescents with T1DM had a significantly larger foveal avascular zone (FAZ) and lower peripapillary and inside‐disc capillary densities (p < 0.05); with no significant fundus photography difference (p = 0.155) than controls. FAZ was positively correlated and peripapillary and inside‐disc capillary densities were negatively correlated with diabetes‐duration, HbA1c, FGF21, and Tanner stage. FGF21 was significantly higher in T1DM children and adolescents having OCTA changes compared to those with normal OCTA (p = 0.002). Multivariate‐regression revealed that FAZ is independently associated with diabetes‐duration, HbA1c and FGF21. Conclusions OCTA changes start early in children and adolescents with T1DM long before the fundus changes. These changes are correlated with diabetes‐duration, puberty, glycaemic, and FGF21.

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Evaluation of microvascular changes in retinal zones and optic disc in pediatric patients with type 1 diabetes mellitus

Cited by 8 publications

References 30 publications

The relationship between carotid intima-media thickness and microvascular changes in retinal zones and optic disc in patients with type 1 diabetes mellitus

The relationship between carotid intima-media thickness and microvascular changes in retinal zones and optic disc in patients with type 1 diabetes mellitus

Diabetic Retinopathy in Children with Type 1 Diabetes—Occurrence and Screening Using Optical Coherence Tomography

Changes in early optical coherence tomography angiography among children and adolescents with type 1 diabetes: Relation to fibroblast growth factor 21

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