June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
Evaluation of the foveal avascular zone in children with type 1 diabetes using optical coherence tomography with angiography (OCTA)
Author Affiliations & Notes
  • Kim Duong
    SUNY College of Optometry, Springfield, Virginia, United States
    Rutgers New Jersey Medical School , New Brunswick, New Jersey, United States
  • Manan Shah
    Rutgers New Jersey Medical School , New Brunswick, New Jersey, United States
  • Radhika Ragam
    Rutgers New Jersey Medical School , New Brunswick, New Jersey, United States
  • Bernard Szirth
    Rutgers New Jersey Medical School , New Brunswick, New Jersey, United States
  • Footnotes
    Commercial Relationships   Kim Duong, None; Manan Shah, None; Radhika Ragam, None; Bernard Szirth, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 1670. doi:
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      Kim Duong, Manan Shah, Radhika Ragam, Bernard Szirth; Evaluation of the foveal avascular zone in children with type 1 diabetes using optical coherence tomography with angiography (OCTA). Invest. Ophthalmol. Vis. Sci. 2017;58(8):1670.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Previous studies have shown changes in the foveal avascular zone (FAZ) using optical coherence tomography with angiography (OCTA) in adults with Type 2 diabetes mellitus (DM). We evaluated the FAZ area using OCTA in children with Type 1 DM in this retrospective clinical study as a screening and recommendation follow-up tool for children with DM.

Methods : Data including visual acuity, automated blood pressure, optical coherence tomography (OCT), OCTA, and color and autofluorescence digital retinal images were collected from children with Type I DM. Subjects were grouped based on age, gender, duration of diabetes and HbA1c level. The AngioVue OCTA system (Optovue, Inc., Fremont, CA, USA) was used to measure the FAZ area. Two-sample t-tests were calculated to determine the difference in FAZ area among patients of different ages, gender, and duration of diabetes.

Results : This study included 101 children with Type 1 DM with an average HbA1c of 7.62 ± 1.24, average duration of diabetes of 6.15 ± 3.86 years (range 1.0-17.0 years), mean systolic blood pressure of 107 ± 14.68, mean diastolic blood pressure of 66.81 ± 9.18, and an average FAZ area of 0.25mm2 ± 0.11 mm2. No significant difference in FAZ area was found among the different age groups, duration of diabetes, or HbA1c level (p>0.05). Males (0.22 mm2) were found to have a smaller FAZ area than females (0.27 mm2) (p = 0.02).

Conclusions : The current recommendations for diabetic screenings are 5 years after diagnosis of Type 1 DM or at the start of age 10. Our study proposes a baseline screening at the time of diagnosis using imaging technologies including OCTA, color and autofluorescence retinal images, along with visual acuity and blood pressure. The FAZ may demonstrate early changes associated with macular edema. While our data does not support a significant correlation between FAZ area and age, duration of diabetes and level of HbA1c, OCTA may still be a beneficial screening tool that will allow clinicians to track longitudinal changes in the FAZ area if screened at time of diagnosis. The significant difference in FAZ area between genders needs to be further investigated especially in longer duration subjects with Type 1 DM.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.

 

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