Abstract
Purpose :
An estimated 8.4 million people worldwide have been diagnosed with Type 1 Diabetes Mellitus (T1DM). Individuals with T1DM may experience retinal changes from poorly controlled blood glucose over 10 years post onset. We studied the relationship of years with T1DM and Ganglion Cell Complex (GCC) thinning using trend analysis software.
Methods :
Fifty patients (58% female, average 25 years old and T1DM for 17 years) were imaged annually using Optovue Avanti RTVue OCT from 2016-2022 at the Children with Diabetes Conference. No imaging was performed in 2020-2021 during the pandemic. Changes in superior and inferior hemispheric GCC and percent change in ETDRS grid were recorded over seven years. Optovue’s trend analysis software used linear regression to evaluate patient changes. Patients were stratified by years with T1DM (<10, 10-19, and ≥20). Paired T-tests were used to determine statistical associations.
Results :
Trend analysis used linear regression to calculate the change per year in superior GCC, inferior GCC, and ETDRS grid. Males and females did not differ significantly in any variable. Patients with T1DM for less than 10 years had superior GCC (0.353 µm/yr, p=0.004) and ETDRS (0.260 µm/yr, p=0.008) changes that were significantly better than baseline (0 µm/yr). Patients with T1DM for 10-19 years had positive slopes for superior GCC (0.170 µm/yr), inferior GCC (0.107 µm/yr), and ETDRS (0.159 µm/yr), although not significantly different from baseline. For patients with T1DM over 20 years, superior GCC (-0.205 µm/yr), inferior GCC (-0.447 µm/yr), and ETDRS (-0.327 µm/yr) were lower than baseline, but not statistically significant.
Conclusions :
Overall, patients with T1DM who received regular eye screenings had stable GCC values. Patients with fewer years of T1DM displayed improvement in GCC. The monitoring of retinal health, including GCC, is an important part of yearly screenings. Longitudinal analysis of patient outcomes may be valuable to track progress and triage in times of extenuating need. We demonstrated the value of annual screenings in T1DM patients, who maintained, and in some cases improved, eye health from the pre- to post-COVID era.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.