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Kacy Richmond, Elliot Samuel Crane, Ben Szirth, Albert S Khouri, Saysha Blazier; Subclinical macular OCT changes in type I diabetic patients. Invest. Ophthalmol. Vis. Sci. 2014;55(13):3374.
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To assess the relationship between spectral domain optical coherence tomography (OCT) macular retinal thickness as a function of age and duration of disease in children with type 1 diabetes mellitus (DMI).
91 subjects (182 eyes) were screened at an international conference for children with diabetes mellitus type 1 in Orlando, FL. Age of individuals screened ranged from 2 to 30 yr with a mean of 14.95 and median of 15 yr. Duration of DMI extended from 0.06 to 26 yr, with a mean of 8.12 and median of 7 yr. The average A1C for these individuals was 7.7%. Caucasians represented 89% of eyes screened. A comprehensive screening was performed including non-mydriatic fundus imaging (Canon, CR2 Plus-AF with EOS-60D) and SD-OCT (Optovue, iVue). OCT scans were acquired showing macular thickness (MT), ganglion cell complex (GCC) thickness, and thickness of the perimacular region in all four quadrants 2-4 and 4-6 mm from the fovea. Using simple linear regressions, macular, perimacular and GCC thickness were analyzed as a function of age and duration with DMI.
Prior to clinical manifestations of diabetic retinopathy (DR), superior perimacular and macular changes may be detected by SD-OCT. Of 182 eyes screened, just 2 eyes showed mild non-proliferative DR. The remaining 180 eyes had no clinical signs of DR. Macular thickness increased as a function of age (p=0.01 OD; p=0.001 OS). Trends representing thinning in all perimacular regions as a function of duration of DMI were observed, though only the superior perimacular region showed statistical significance. The thickness of the superior perimacular region (2-4 and 4-6 mm from fovea) decreased as a function of duration of DMI (p=0.024 and 0.022 OD; p=0.058 and 0.026 OS) (Fig 1). No significant trends were observed for GCC. See table for mean and standard deviation values of macular thickness, superior and inferior perimacular region (2-4; 4-6) thickness, and GCC thickness for OD and OS.
In this cohort of young DMI patients macular changes were detected prior to any fundus changes consistent with diabetic retinopathy. These findings highlight the importance of using SD-OCT to detect and follow ocular changes in DMI patients. This warrants a larger study with comparison to a normal reference database.
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