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Early Ophthalmic Artery Blood Flow Parameter Changes in Patients with Type 1 Diabetes Mellitus
Serdar Ozates1, Betul Emine Derinkuyu2, Ufuk Elgin3
1Department of Ophthalmology, Kars Harakani State Hospital, Kars, Turkey.
Insights
Early type 1 diabetes mellitus (DM) in children can cause changes in ocular blood flow. These hemodynamic alterations in the ophthalmic artery (OA) may signal future vascular complications.
Area of Science:
- Ophthalmology
- Diabetology
- Vascular Biology
Background:
- Type 1 diabetes mellitus (DM) is a chronic condition affecting children.
- Early detection of vascular complications in pediatric DM is crucial.
- Ophthalmic artery (OA) blood flow may be an early indicator of diabetic vasculopathy.
Purpose of the Study:
- To evaluate initial changes in ophthalmic artery (OA) blood flow parameters in pediatric patients with type 1 DM.
- To identify potential early markers for vascular complications in young patients with DM.
Main Methods:
- Prospective, cross-sectional, observational study including 31 pediatric patients with type 1 DM and 32 healthy controls.
- Doppler ultrasonography used to measure OA blood flow parameters: peak systolic velocity (PSV), end diastolic velocity (EDV), pulsatility index (PI), and resistivity index (RI).
Main Results:
- Patients with type 1 DM showed significantly higher mean PI and RI compared to controls.
- Mean PSV and EDV were significantly lower in the DM group than in the control group.
- Mean PI (≥1.69) and RI (≥0.75) showed predictive value for vascular hemodynamic changes in type 1 DM.
Conclusions:
- Disturbances in ocular hemodynamics can occur within the first year of type 1 DM diagnosis in children.
- Ocular hemodynamic parameters, specifically PI and RI, may serve as early predictors or screening tools for vascular changes in pediatric type 1 DM.
Objectives:
The aim of this study was to assess initial changes in blood flow parameters of the ophthalmic artery (OA) in pediatric patients with type 1 diabetes mellitus (DM).
Methods:
Sixty-three subjects were included in this prospective, cross-sectional, observational study. Thirty-one (49.2%) patients with type 1 DM without diabetic retinopathy formed the DM group. The control group comprised 32 (50.8%) healthy subjects. The OA of all of the patients was examined with Doppler ultrasonography. The main outcomes were peak systolic velocity (PSV), end diastolic velocity (EDV), pulsatility index (PI), and resistivity index (RI) measurements.
Results:
The mean age at onset of type 1 DM was 10.7±2.0 years and the mean duration was 11.4±11.0 months. The mean PSV and EDV outcomes in both eyes were significantly higher in the control group than in the DM group, whereas, the mean PI and RI outcomes in both eyes were significantly higher in the DM group (p<0.05). A mean RI of ≥0.75 indicated vascular hemodynamic changes associated with type 1 DM with a sensitivity of 72% and a specificity of 65% (area under the curve: 0.702; p=0.007). A mean PI of ≥1.69 predicted vascular hemodynamic changes associated with type 1 DM with a sensitivity of 79% and a specificity of 71% (area under the curve: 0.742; p=0.001).
Conclusion:
The results of this study revealed that disturbances in ocular hemodynamics might be present as early as the first year after a type 1 DM diagnosis. Changes in ocular hemodynamic parameters could be used to predict or screen for the development of vascular changes.
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