ArticleIrish journal of medical science2026
Early selective deep capillary plexus impairment at diagnosis in children with type 1 diabetes: an OCT angiography study.
Article in Irish journal of medical science, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundRetinal microvascular dysfunction may precede clinically visible diabetic retinopathy in children with type 1 diabetes mellitus (T1DM), but whether it is detectable at diagnosis remains unclear.
aimsTo evaluate retinal microvascular alterations at T1DM diagnosis using optical coherence tomography angiography (OCTA) and assess associations between deep capillary plexus (DCP) vessel density and metabolic severity.
methodsThis cross-sectional study included 50 children with newly diagnosed T1DM (100 eyes) and 50 age- and sex-matched controls (100 eyes). OCTA was performed using 6×6-mm macular and 4.5×4.5-mm optic disc scans. Vessel density (VD) was assessed in the superficial capillary plexus (SCP), DCP, and radial peripapillary capillary network. Foveal avascular zone metrics and retinal nerve fiber layer thickness were also analyzed. Linear mixed-effects models accounted for inter-eye correlation. Subgroup analyses were performed by HbA1c level and diabetic ketoacidosis (DKA) severity.
resultsSCP VD did not differ significantly between groups. DCP VD was lower in T1DM eyes in the whole image (53.1±3.0% vs 54.6±2.8%, p=0.006), parafoveal region (54.0±3.1% vs 55.8±2.9%, p=0.002), and perifoveal region (53.4±3.0% vs 54.7±2.8%, p=0.02). Peripapillary VD and retinal nerve fiber layer thickness were similar. Higher HbA1c was independently associated with lower DCP VD, which also declined with increasing DKA severity.
conclusionsDCP impairment is detectable at T1DM diagnosis before clinically visible diabetic retinopathy. OCTA may provide a sensitive, noninvasive biomarker of early retinal microvascular involvement in pediatric T1DM.
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