Endocrine Abstracts

JOINT500

Purpose: To investigate three-year changes in retinal neurovascular structure in children and adolescents with type 1 diabetes (T1D) without clinical diabetic retinopathy using optical coherence tomography (OCT) and OCT angiography (OCTA).

Methods: This prospective, cross-sectional, observational study included T1D patients without DR, assessed between May and September 2022 (T1D-C group). Retinal neurovascular structures in the macular and peripapillary regions were quantitatively analyzed using OCT and OCTA and compared with data collected three years prior (T1D-P group). Associations with Tanner’s pubertal stage, diabetes duration, and HbA1c were assessed. Statistical significance was set at P < 0. 05.

Results: Ninety-two eyes from 46 T1D patients were included. The T1D-C group exhibited significantly lower vessel densities(VDs) in the foveal and parafoveal superficial capillary plexuses(SCP) and deep CP(DCP) compared to the T1D-P group. Conversely, central foveal thickness, central inner retinal thickness, peripapillary retinal nerve fiber layer thickness (pRNFLT), and nasal inferior disc VD were significantly higher in the T1D-C group (p < 0. 05 for all). Tanner’s pubertal stage was significantly and negatively correlated with SCP VDs (r = -0. 345 to –0. 166, p <0. 001) and inferior nasal and temporal disc VDs. HbA1c and diabetes duration negatively correlated with foveal avascular zone diameter(r = -0. 346 and –0. 267; respectively, p < 0. 01) and SCP/DCP VDs (p <0. 05).

Conclusion: In young T1D patients, while initial peripapillary microvascular changes may be more pronounced, macular microvasculature shows significant decline over three years. Concurrently, foveal retinal thickness and pRNFLT increase. These findings highlight the importance of longitudinal monitoring of retinal neurovascular structure in young T1D patients, even in the absence of clinical DR.