Purpose
To analyze spectral domain optical coherence tomography (SDOCT) findings in patients with Type 1 Diabetes (DMI) with normal fundus examination.
Methods
109 subjects were screened (mean age 14.32, range 5-30 yrs) during The International Conference for Children with DMI in Orlando, FL. The mean duration of DMI was 7.82 yr (range 0.4 to 25 yr) and the mean HbA1C for these individuals was 7.9%. Of these, 56% were females, 79% were Caucasians and the visual acuity was 20/20 for 57% of right eye and 61% of left eye. 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) and thickness of the parafoveal regions (2-4mm from fovea) and the perifoveal regions (4-6mm from fovea). The subjects were divided into three age groups: 6-8, 9-14 and 15-30 yr. Associations of macular, paramacular and perimacular thickness were analyzed as a function of HbA1C and Body Mass Index (BMI) by simple linear regressions.
Results
SDOCT measured ultrastructural discrepancies in the macula, paramacula and perimacula regions. Linear regression analysis of thickness of macula OD, paramacula OD, paramacula OS, perimacula OD with BMI were statistically significant (p <.05). HbA1C >7.5% was also found statistically significant in the macula OS, paramacula OD, paramacula OS, perimacula OD and perimacula OS. (Table 1) A general trend of thickening of the macula, paramacula and perimacula was observed with increasing HbA1C (>7.5%) and increasing BMI; however, no statistical significance was found. (Table 2)
Conclusions
SDOCT with retinal imaging was feasible in young individuals and revealed ultrastructural macular and perimacular changes in subjects with DMI prior to manifested clinical disease. A reference data base for comparison will further our understanding of these changes and warrants a larger study that will include SDOCT in patients with DMI.