Early Retinal Microvascular Changes Assessed with Swept-Source OCT Angiography in Type 1 Diabetes Patients without...

Area of Science:

• Ophthalmology
• Endocrinology
• Medical Imaging

Background:

• Diabetic retinopathy, a complication of type 1 diabetes, can cause vision loss.
• Retinal microvascular alterations precede clinical signs of diabetic retinopathy.
• Optical coherence tomography angiography (OCT-A) allows detailed analysis of retinal vasculature.

Purpose of the Study:

• To investigate retinal vascular parameters using OCT-A in type 1 diabetes patients without retinopathy.
• To compare these parameters with non-diabetic controls.
• To explore correlations with diabetes management, including insulin intake and continuous glucose monitoring devices.

Main Methods:

• Cross-sectional study conducted at Dijon University Hospital (2018-2020).
• Macular OCT-A used to measure vascular densities in superficial (SCP) and deep (DCP) capillary plexuses.
• 98 type 1 diabetes patients and 71 non-diabetic volunteers were enrolled.

Main Results:

• Significantly lower vascular density in the SCP's inner circle in diabetes patients (p < 0.01).
• Correlation found between DCP's central vascular density and daily insulin intake (p = 0.042).
• FreeStyle Libre (FSL) device use associated with higher vascular densities in both SCP and DCP (p < 0.05 for all significant findings).

Conclusions:

• Retinal microvascularization is altered early in type 1 diabetes.
• The FreeStyle Libre device may play a role in preserving retinal microvasculature.
• OCT-A is a valuable tool for detecting early vascular changes in diabetes.