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Kim Duong, Mike Ferm, Ariel Omiunu, Albert S Khouri, Ben Szirth; Longitudinal OCTA Analysis of Children with Type I Diabetes Mellitus. Invest. Ophthalmol. Vis. Sci. 2019;60(9):3021. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
The American Academy of Ophthalmology suggests full ocular screening at age 15- or 5-years post diagnosis of Type 1 diabetes (T1DM). Previous studies have shown changes in retinal vasculature preceding signs of diabetes using Optical Coherence Tomography with Angiography (OCTA) in adults with Type 2 diabetes. However, the role of Foveal Avascular Zone (FAZ) and vessel density using OCTA has not been well established in the initial years of T1DM. We evaluated in this exploratory longitudinal retrospective analysis when changes manifest in the FAZ and vessel density using OCTA in this cohort with Type 1 DM clinical.
Visual acuity, blood pressure, medical history, optical coherence tomography (OCT), OCTA, and color and autofluorescence digital retinal images were collected from children with Type I DM. OCTA (AngioVue Optovue, Inc., Fremont, CA, USA) was used to measure the FAZ area, superficial vessel density (SVD) within a 3x3mm area centered on the fovea, and parafoveal vessel density (FD) within a 300um ring around the FAZ. Friedman test was used to determine changes in FAZ, whole SVD and FD over two years (2016-2018) using the right eye. Spearman’s Rho test was used to determine correlations between FAZ, SVD, FD and HbA1c.
Study included 14 children with Type 1 DM without retinopathy. Mean age was 10.48 ± 4.35 at time of enrollment. The average HbA1c was 7.90 ± 0.49 and average duration of diabetes of 8.5 ± 3.70 years in 2018. There was no significant change in the FAZ (p=0.30), SVD (p=0.47) and FD (p=0.26) in each of the three time points over two years (2016, 2017, 2018). There were no correlations in FAZ and HbA1C in 2016 (p=0.90), 2017 (p=0.84), or 2018 (p=0.12). There were no correlations between duration of diabetes with SVD (p=0.06) or FD (p=0.07) and HbA1c with SVD (p=0.25) or FD (p=0.20) in 2018.
No significant changes in FAZ, SVD, or FD in this <15 years with T1DM cohort using OCTA in this exploratory evaluation. No correlations between duration of diabetes or HbA1c with changes in FAZ, whole SVD, or FD. Usefulness of OCTA in understanding changes in retinal vasculature in TIDM during a lifelong condition suggests the importance of baseline measurement at time of diagnosis for future follow-up.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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