Department of Endocrinology and Diabetology, The Children's Memorial Health Institute, Warsaw, Poland.
Department of Ophthalmology, The Children's Memorial Health Institute, Warsaw, Poland.
J Diabetes Res. 2020 Nov 18;2020:4742952. doi: 10.1155/2020/4742952. eCollection 2020.
To evaluate the influence of metabolic parameters and the treatment method in children with type 1 diabetes (T1D) on the optical coherence tomography angiography (OCTA) results as early markers of diabetic retinopathy (DR). . This prospective study enrolled 175 consecutive children with T1D. OCTA was performed using AngioVue (Avanti, Optovue). Whole superficial capillary vessel density (wsVD), fovea superficial vessel density (fsVD), parafovea superficial vessel density (psVD), whole deep vessel density (wdVD), fovea deep vessel density (fdVD), parafovea deep vessel density (pdVD), foveal thickness (FT), parafoveal thickness (PFT), and foveal avascular zone (FAZ) in superficial plexus were evaluated and analyzed in relation to individual characteristics, i.e., sex, weight, height, body mass index (BMI), and metabolic factors: current and mean value of glycated hemoglobin A1c (HbA1c). Furthermore, the analysis concerned the diabetes duration, age at the T1D onset, and type of treatment-multiple daily insulin injections (MDI) or continuous subcutaneous insulin infusion (CSII).
In the study group, we did not identify any patient with DR in fundus ophthalmoscopy. Age at the onset of diabetes correlated negatively with FAZ ( = -0.17, < 0.05). The higher level of HbA1c corresponded to a decrease of wsVD ( = -0.13, < 0.05). We found significantly lower fsVD (32.25 ± .1 vs. 33.98 ± .1, < 0.01), wdVD (57.87 ± .1 vs. 58.64 ± .9, < 0.01), and pdVD (60.60 ± .2 vs. 61.49 ± .1, < 0.01) and larger FAZ area (0.25 ± .1 vs. 0.23 ± .1, < 0.05) in the CSII vs. MDI group.
The metabolic parameters, age of the onset of diabetes, and treatment method affected the OCTA results in children with T1D. Further studies and observation of these young patients are needed to determine if these findings are important for early detection of DR or predictive of future DR severity.
评估代谢参数和治疗方法对 1 型糖尿病（T1D）儿童光学相干断层扫描血管造影（OCTA）结果的影响，这些结果可作为糖尿病视网膜病变（DR）的早期标志物。本前瞻性研究纳入了 175 例连续的 T1D 患儿。使用 AngioVue（Avanti，Optovue）进行 OCTA。评估并分析了浅层毛细血管总血管密度（wsVD）、黄斑浅层血管密度（fsVD）、旁黄斑浅层血管密度（psVD）、深层毛细血管总血管密度（wdVD）、黄斑深层血管密度（fdVD）、旁黄斑深层血管密度（pdVD）、黄斑中心凹厚度（FT）、旁黄斑中心凹厚度（PFT）和浅层丛状层中黄斑中心凹无血管区（FAZ）与个体特征（性别、体重、身高、体重指数（BMI）和代谢因素：当前和糖化血红蛋白 A1c（HbA1c）的平均值）之间的关系。此外，还分析了糖尿病病程、糖尿病发病年龄和治疗类型（多次胰岛素注射（MDI）或持续皮下胰岛素输注（CSII））。
在研究组中，眼底镜检查未发现任何 DR 患者。糖尿病发病年龄与 FAZ 呈负相关（ = -0.17， < 0.05）。HbA1c 水平越高，wsVD 越低（ = -0.13， < 0.05）。我们发现 CSII 组的 fsVD（32.25 ±.1 比 33.98 ±.1， < 0.01）、wdVD（57.87 ±.1 比 58.64 ±.9， < 0.01）和 pdVD（60.60 ±.2 比 61.49 ±.1， < 0.01）显著降低，FAZ 面积增大（0.25 ±.1 比 0.23 ±.1， < 0.05）。
代谢参数、糖尿病发病年龄和治疗方法影响 T1D 患儿的 OCTA 结果。需要对这些年轻患者进行进一步的研究和观察，以确定这些发现是否对 DR 的早期检测重要，或者是否对未来 DR 的严重程度具有预测性。
