Vasilijevic Jelena, Kovacevic Igor, Polovina Snezana, Dacic-Krnjaja Bojana, Kalezic Tanja, Miletic Suzana, Al Barri Leila, Stanca Simona, Ferrari Francis, Jesic Maja
Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia.
Clinic for Eye Diseases, Clinical Centre of Serbia, 11000 Belgrade, Serbia.
J Pers Med. 2024 Jun 28;14(7):696. doi: 10.3390/jpm14070696.
(1) Background: This study aims to evaluate retinal perfusion by optical coherence tomography angiography (OCTA) in pediatric patients with type 1 diabetes mellitus (T1D) without diabetic retinopathy (DR). (2) Methods: Thirty-one patients affected by T1D were enrolled. All participants were evaluated using OCTA. The foveal avascular zone (FAZ) and superficial and deep macular vessel density (VD) were analyzed. The correlation of these parameters with metabolic factors such as body mass index (BMI), glycated hemoglobin (HbA1c), and the type of insulin therapy (multiple daily injections, MDI vs. continuous subcutaneous insulin infusion, CSII) was determined. (3) Results: None of the OCTA parameters were significantly different between the groups. The patients' HbA1C level did not influence any of the OCTA parameters. The use of MDI tended to reduce the parafoveal and perifoveal deep VD ( = 0.048 and = 0.021, respectively) compared to CSII. An elevated BMI tended to increase the deep macular ( = 0.005) and perifoveal VD ( = 0.006). (4) Conclusion: VD and FAZ are normal in pubescent children with T1D without signs of DR. Treatment with CSII may be a better choice compared to MDI, as CSII may be protective against retinal microvascular damage. Our results indicate the need for new clinical parameters of glycemic control in addition to HbA1c which could assess the risk of DR.
(1) 背景：本研究旨在通过光学相干断层扫描血管造影（OCTA）评估1型糖尿病（T1D）且无糖尿病视网膜病变（DR）的儿科患者的视网膜灌注情况。(2) 方法：招募了31名患有T1D的患者。所有参与者均接受OCTA评估。分析了黄斑无血管区（FAZ）以及黄斑浅层和深层血管密度（VD）。确定了这些参数与体重指数（BMI）、糖化血红蛋白（HbA1c）等代谢因素以及胰岛素治疗类型（多次皮下注射，MDI与持续皮下胰岛素输注，CSII）之间的相关性。(3) 结果：各组之间的OCTA参数均无显著差异。患者的HbA1C水平对任何OCTA参数均无影响。与CSII相比，使用MDI往往会降低黄斑旁和黄斑周围深层VD（分别为 = 0.048和 = 0.021）。BMI升高往往会增加黄斑深层（ = 0.005）和黄斑周围VD（ = 0.006）。(4) 结论：在无DR迹象的青春期T1D儿童中，VD和FAZ正常。与MDI相比，CSII治疗可能是更好的选择，因为CSII可能对视网膜微血管损伤具有保护作用。我们的结果表明，除了HbA1c之外，还需要新的血糖控制临床参数来评估DR风险。
