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Updated: Jul 6, 2026
Retinal Vascular Reactivity as Assessed by Optical Coherence Tomography Angiography
Published on: March 26, 2020
Quantifying peripapillary vessel density and retinal nerve fibre layer in type 1 diabetic children without clinically
Ling Chen1, Yun Feng1, Sha-Sha Zhang1
1Xi'an Children's Hospital Affiliated to Xi'an Jiaotong University, Xi'an 710002, Shaanxi Province, China.
Insights
Children with type 1 diabetes show reduced peripapillary vessel density and retinal nerve fiber layer thickness before retinopathy develops. Optical coherence tomography angiography aids in early detection of these changes.
Area of Science:
- Ophthalmology
- Diabetology
- Medical Imaging
Background:
- Type 1 diabetes (T1D) can lead to diabetic retinopathy.
- Early detection of microvascular changes is crucial for managing T1D complications.
- Optical coherence tomography angiography (OCTA) offers high-resolution imaging of retinal vasculature.
Purpose of the Study:
- To quantify changes in peripapillary vessel density (ppVD) and peripapillary retinal nerve fiber layer (pRNFL) in children with T1D.
- To assess these changes in the absence of clinically detectable diabetic retinopathy.
- To establish a basis for early retinopathy detection in pediatric T1D using OCTA.
Main Methods:
- Retrospective study including 30 children with T1D (3-14 years) without retinopathy (NDR group) and 30 healthy controls (CON group).
- OCTA was used to measure mean pRNFL thickness and ppVD in four quadrants (nasal, inferior, temporal, superior).
- HbA1c levels were recorded for the NDR group; statistical analysis compared groups and correlated findings.
Main Results:
- The NDR group exhibited significantly decreased nasal and superior ppVD compared to controls (P<0.01).
- Nasal pRNFL thickness was significantly reduced (P<0.01), with non-significant decreases in other quadrants.
- No significant correlation was found between ppVD, pRNFL, HbA1c, or diabetes duration.
Conclusions:
- Children with T1D demonstrate reduced ppVD and pRNFL even before clinical signs of retinopathy appear.
- OCTA is a valuable tool for the early monitoring of microvascular and neural retinal changes in pediatric T1D.
- These findings support OCTA's role in the early detection of diabetic retinopathy in children.
Aim:
To quantify changes in radial peripapillary capillary vessel density (ppVD) and the peripapillary retinal nerve fiber layer (pRNFL) in children with type 1 diabetes without clinical diabetic retinopathy by optical coherence tomography angiography (OCTA), providing a basis for early retinopathy in children with type 1 diabetes.
Methods:
This was a retrospective study. A total of 30 patients (3-14y) with type 1 diabetes without clinical diabetic retinopathy (NDR group) were included. A total of 30 age-matched healthy subjects were included as the normal control group (CON group). The HbA1c level in the last 3mo was measured once in the NDR group. The pRNFL thickness and ppVD were automatically measured, and the mean pRNFL and ppVD were calculated in the nasal, inferior, temporal, and superior quadrants. The changes in ppVD and pRNFL in the two groups were analyzed.
Results:
Compared with CON group, the nasal and superior ppVDs decreased in the NDR group (all P<0.01). The thickness of the nasal pRNFL decreased significantly (P<0.01), while the inferior, temporal and superior pRNFLs slightly decreased but not significant in the NDR group (all P>0.05). Person and Spearman correlation analysis of ppVD and pRNFL thickness in each quadrant of the NDR group showed a positive correlation between nasal and superior (all P<0.01), while inferior and temporal had no significant correlation (all P>0.05). There was no significant correlation between the HbA1c level and ppVD and pRNFL in any quadrant (all P>0.05). There was no significant correlation between the course of diabetes mellitus and ppVD and pRNFL in any quadrant (all P>0.05).
Conclusion:
ppVD and pRNFL decrease in eyes of children with type 1 diabetes before clinically detectable retinopathy and OCTA is helpful for early monitoring．.
