Neuroretinal Layer Thinning on OCT Imaging and Hemoglobin A1c in Youth With Type 1 Diabetes.
Thinner ganglion cell and inner plexiform retinal layer linked to higher HbA1c in youth
Neuroretinal Layer Thinning on OCT Imaging and Hemoglobin A1c in Youth With Type 1 Diabetes.
IMPORTANCE: Diabetic retinal neurodegeneration precedes vascular changes associated with diabetic retinal disease (diabetic retinal disease).
To determine if retinal layer thickness changes on optical coherence tomography (optical coherence tomography) imaging were associated with glycemic outcomes and diabetic retinal disease in youth.
DESIGN, SETTING, AND PARTICIPANTS: This prospective cohort study was conducted at an academic pediatric diabetes center among youth with T1D aged 9 to 21 years participating in the ACCESS2 (AI for Pediatric Diabetic Eye Exams Study 2) study.
higher HbA1c linked to thinner retinal nerve cell layer, a sign of nerve damage
Participants had a median (IQR) duration of diabetes of 7.0 (4.6-10.1) years and a median (IQR) hemoglobin A1c (HbA1c) of 8.5% (7.5%-9.9%); 210 participants (71.4%) used an insulin pump.
Of the total 578 eyes, 65 eyes (11.2%) had mild diabetic retinal disease and 10 eyes (1.73%) had moderate diabetic retinal disease.
In adjusted analyses, moderate diabetic retinal disease vs no diabetic retinal disease was associated with retinal nerve fiber layer thickness of -1.2 µm (95% CI, -2.9 to 0.5; P = .20), GCL+IPL thickness of -1.2 µm (95% CI, -2.8 to 0.4; P = .19), and outer retinal layer thickness of -0.8 µm (95% CI, -3.9 to 2.2; P = .80).
In this prospective cohort study, neuroretinal layer thinning was observed in youth with T1D without clinically apparent diabetic retinal disease and was associated with higher HbA1c.
These findings support elucidating the development of diabetic retinal neurodegeneration and its potential role as a biomarker of retinal vascular disease in youth.