Ocular manifestations of Type 1 diabetes mellitus in pediatric population

Abstract

Context:To evaluate the necessity of ocular screening in Type 1 diabetes mellitus (DM).Aims:This study aims to investigate the diabetes-related ocular changes according to the glycosylated hemoglobin (HbA1c) level and duration of diabetes in children and compare the results with nondiabetic healthy children.Settings and Design:Observational cross-sectional study designed by ophthalmology and pediatric endocrinology clinics.Subjects and Methods:Forty-two children with Type 1 DM, 42 healthy gender- and age-matched children as controls were enrolled. All patients underwent ophthalmic and physical examination, with a review of medical history and current medication. HbA1c level, best corrected visual acuity, intraocular pressure (IOP), central corneal thickness (CCT), tear break-up time (BUT), Schirmer test, dilated fundus examination findings, central retinal thickness (CRT), and total macular volume (TMV) measurements were noted.Statistical Analysis:Descriptive statistics, Student's t-test, Mann–Whitney U-test, Chi-square test for comparison of the group parameters and correlation analyses (Spearman analysis) were performed with SPSS statistical software 17.0 (SPSS Inc., Chicago, IL, USA).Results:Type 1 DM group exhibited significantly reduced Schirmer test, increased IOP and decreased retinal thickness relative to the age-matched control group (P < 0.05) but no statistically significant difference was found for the BUT (P = 0.182) and for the CCT (P = 0.495). The correlations between the age, duration, HbA1c and IOP, BUT, Schirmer test, TMV, CRT measurements did not reach statistical significance.Conclusions:More frequent screening may be needed for complications, including neuropathy-related dry eye syndrome, IOP changes, and diabetic retinopathy in children with Type 1 DM.

Quantitative evaluation of early retinal changes in children with type 1 diabetes mellitus without retinopathy

“…Previous studies revealed alterations in the macular thickness measurements of type 1 or type 2 diabetic patients with and without DR. [14][15][16] However, only the children with well-controlled type 1 DM who had full visual acuity in both eyes and no sign of DR after a fundoscopic examination and fundus photographs were included in our study. Akil et al 17 investigated the alterations in the anterior and posterior segment findings of children with type 1 DM with and without DR and found that the measurements of total macular volume and central retinal thickness were significantly lower in the diabetic group than in controls. Van Dijk et al 18 investigated which retinal layers are most affected by diabetes in patients with type 1 DM who have no or minimal DR and demonstrated that thinning occurs in inner retinal layers, particularly the ganglion cell layer.…”

The relationship between blood sugar levels (glycosylated haemoglobin) and the risk of development of diabetic retinopathy

“…In children, frequent screening should be recommended for neuropathy related complications such as dry eye syndrome, glaucoma and diabetic retinopathy in Type1 diabetes mellitus. This is because a longer duration of diabetes can cause microvascular involvement and long term follow up is also required [15]. Inflammation can…”

Prevalence of Dry Eye Syndrome in Patients With Type 1 and Type 2 Diabetesa Comparative Study

“…Positive patients showed significant trend with both enhancing age and duration of DM (Table 2) with no significant statistical difference between the two groups (data not shown). Age (years) 30-39 0 (0) 0.005 0 (0) 0.01 0 (0) < 0.001 0 (0) 0.007 40-49 0 (0) 0 (0) 0 (0) 0 (0) 16,[23][24][25][26] However, to the best of our knowledge, no study till date has tried to compare the prevalence of dry eye syndrome between patients of Type 1 and Type 2 diabetes, especially with focus on the Eastern-Indian population.…”