ArticleDiagnostics (Basel, Switzerland)2023
Early Retinal Microvascular Alterations in Young Type 1 Diabetic Patients without Clinical Retinopathy.
Article in Diagnostics (Basel, Switzerland), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 16 citations in OpenAlex.
- Divergent nasal-temporal changes in superficial vascular density as early biomarkers of diabetic retinopathy.BMC ophthalmology · 2026Observational
- OCT Angiography Assessment of Type 1 Diabetes Mellitus Patients Without Diabetic Retinopathy: A 3-Year Follow-Up Study.Diagnostics (Basel, Switzerland) · 2025Article
- Optical coherence tomography angiography in non-alcoholic fatty liver disease: is it a disease affecting the microvascular system??BMC ophthalmology · 2025Article
- Peripheral blood HIF-1α levels: a study on their predictive ability for early-stage diabetic retinopathy.Endocrine connections · 2025Article
- The novel antidiabetic medications on diabetic retinopathy: relevant molecular mechanisms, advancing diagnostic innovations, and therapeutic implications.Frontiers in medicine · 2025Review
- Neurofibromatosis Type 1-Retinal Alterations Detectable with Optical Coherence Tomography Angiography.Diagnostics (Basel, Switzerland) · 2024Article
- Correlations between Retinal Microvascular Parameters and Clinical Parameters in Young Patients with Type 1 Diabetes Mellitus: An Optical Coherence Tomography Angiography Study.Diagnostics (Basel, Switzerland) · 2024Article
- Retinal Functional Impairment in Diabetic Retinopathy.Biomedicines · 2023Article
- Retinal Microvascular Alterations in a Patient with Type 1 Diabetes Mellitus, Hemoglobin D Hemoglobinopathy, and High Myopia-Case Report and Review of the Literature.Diagnostics (Basel, Switzerland) · 2023Article
- Automated Stabilization, Enhancement and Capillaries Segmentation in Videocapillaroscopy.Sensors (Basel, Switzerland) · 2023Article
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Authors and funding
9 authors at 1 institution in 1 country.
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Abstract
The purpose of this study is to identify and quantify preclinical changes with the help of optical coherence tomography angiography (OCTA) within the retinal microcirculation of young type 1 diabetes (T1D) patients without clinical signs of diabetic retinopathy (DR) and to compare these results with those obtained from healthy age-matched subjects. OCTA is currently used for monitoring diabetic retinopathy; however, there is no current consensus on which OCTA parameter alterations predict the first clinical signs of diabetic retinopathy. The main challenge that young patients with T1D face during the course of the disease is that they can rapidly progress to the development of DR, especially during adolescence. Moreover, they also present an increased risk of rapid progression toward advanced stages of DR and vision loss compared to type 2 diabetes patients, indicating the importance of early diagnosis and intervention. The limitations of the currently used screening procedures that led to the conceptualization of our study are the difficulties in performing fluorescein angiography tests for diagnosing the clinical signs of DR on young patients, namely the invasive procedure of dye injection, the risk of allergic reactions and the long duration of the examination. Moreover, given the long life expectancy of young T1D patients, it is essential to identify the preclinical changes in retinal microvasculature before reaching the first clinical signs quantifiable by FFA. The clinical study enrolled 119 subjects aged between 4 and 30 years old with a mean age of 13 years old, comprising 61 T1D patients with a mean duration of the disease of 4 years and 8 months and 58 healthy age-matched subjects for the control group. OCTA scans were performed using the RevoNX 130 OCTA device (Optopol) to evaluate the following retinal parameters: foveal avascular zone (FAZ) area, perimeter and circularity, overall foveal thickness, and superficial and deep vessel densities. Statistically significant differences between the two groups were identified for the following parameters: the FAZ area in the T1D group (0.42 ± 0.17) was larger than the control group (0.26 ± 0.080), the FAZ circularity (0.41 ± 0.11) was decreased compared to the control group (0.61 ± 0.08) and the FAZ perimeter was larger (3.63 ± 0.97) compared to the control group (2.30 ± 0.50). The overall foveal thickness was decreased in the T1D group (222.98 ± 17.33) compared to the control group (230.64 ± 20.82). The total vessel density of the superficial capillary plexus (SCP) on an investigated area of 6 X 6 mm centered around the fovea was decreased in the T1D group (37.4164 ± 2.14) compared to the control group (38.0241 ± 2.44). Our data suggest that specific imaging biomarkers such as FAZ perimeter, area and circularity, decreased overall foveal thickness and decreased vessel density in the SCP precede the clinical diagnosis of DR in young T1D patients and represent useful parameters in quantifying capillary nonperfusion in T1D patients without clinical signs of DR.
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