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Changes in ocular pulse amplitude and posterior ocular structure parameters in type 1 diabetic children without

Abdulvahit Asik1, Semih Bolu2, Ilke Direkci3

  • 1Department of Pediatrics, Adıyaman University Education and Research Hospital, Adıyaman, Turkey.

Therapeutic Advances in Ophthalmology
|July 14, 2022
PubMed

Insights

Children with type 1 diabetes mellitus show higher intraocular pressure and ocular pulse amplitude, with thinner choroidal thickness, ganglion cell layer, and retinal nerve fiber layer compared to healthy controls. Choroidal thickness may indicate early retinal changes in pediatric diabetes.

Area of Science:

  • Ophthalmology
  • Diabetology
  • Pediatrics

Background:

  • Early detection of posterior ocular structure changes is crucial in pediatric patients with type 1 diabetes mellitus (DM) before the onset of retinopathy.
  • Understanding these early changes can inform preventative strategies and management.

Purpose of the Study:

  • To evaluate inner plexiform layer (IPL), ganglion cell layer (GCL), and retinal nerve fiber layer (RNFL) thicknesses in children with type 1 DM without diabetic retinopathy (DR).
  • To assess the relationship between choroidal thickness (CT) and ocular pulse amplitude (OPA) in this cohort.
  • To identify potential early biomarkers of retinal involvement in pediatric type 1 diabetes.

Main Methods:

  • A prospective observational study comparing 44 pediatric patients with type 1 DM (Group 1) and 65 healthy pediatric controls (Group 2).
  • Measurements included intraocular pressure (IOP) and OPA via dynamic contour tonometer.
  • Spectral domain optical coherence tomography (OCT) was used to measure CT, IPL, GCL, and RNFL.

Main Results:

  • Group 1 exhibited significantly higher IOP (16.67±2.34 mmHg) and OPA (1.85±0.34) compared to Group 2 (15.14±2.17 mmHg, 1.65±0.25; p<0.001 for both).
  • Subfoveal CT was significantly lower in Group 1 (294.30±67.61 μm) than in Group 2 (394.42±69.65 μm; p<0.001).
  • GCL (1.09±0.11 vs 1.14±0.09; p=0.005) and RNFL (96.46±11.69 vs 101.73±9.33; p=0.008) were thinner in Group 1.

Conclusions:

  • Children with type 1 DM show elevated IOP and OPA, alongside reduced CT, GCL, and RNFL thickness, even in the absence of DR.
  • These findings suggest that CT may serve as an early indicator of retinal changes in pediatric patients with type 1 DM.
  • Early ocular structural changes in pediatric diabetes warrant further investigation and monitoring.
Abstract

Keywords:
EDI mode OCTchoroidal blood flowchoroidal thicknessdynamic contour tonometryocular pulse amplitudetype 1 diabetes mellitus

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