Pediatric patients with diabetes might benefit from regular screenings with spectral-domain optical coherence tomography (SD-OCT) to catch early choroidal thickening, according to new research. An international team recently discovered that changes in the choroid occur in children with diabetes mellitus and seem to progress with disease duration. The new study, recently published in Retina, also found choroidal thickness increased despite the lack of other signs of diabetic retinopathy (DR) and without retinal thickening. While other studies have already documented similar findings in adults, this is the first to look closely at the pediatric population.1
The researchers studied 121 children with diabetes—ages six through 18—and 32 age-matched controls. The study participants were divided into three groups: those with the condition for less than five years (group 1), five to 10 years (group 2) and more than 10 years (group 3). Using SD-OCT, researchers found group 3 had significantly thicker choroids, an average of 367.4μm, than the controls (305.5μm) and both groups 1 and 2 (309.2μm and 315.2μm, respectively).1
The researchers note the data contradicts other studies that found no significant difference from controls in choroidal thickness between children with diabetes without DR.2,3 However, the earlier studies had small study groups that were hampered by the significant variability of the disease. The current, larger study group also includes a significantly longer duration of diabetes, with a maximum of 15.9 years, compared with zero to 10 years for the earlier studies.1
The findings could lead to a new screening opportunity, the authors write—an important need, considering “children are at high risk of developing
DR in adulthood because of long diabetes mellitus duration,” the study says. Identifying and tracking choroidal thickening early could help clinicians better counsel patients about the importance of good glycemic control to reduce the risk of possible ocular sequelae such as diabetic choroidopathy and DR.
1. Niestrata-Ortiz M, Fichna P, Stankiewicz W, Stopa M. Determining the effect of diabetes duration on retinal and choroidal thicknesses in children with type 1 diabetes mellitus. Retina. December 18, 2018. [Epub ahead of print].
2. Sayin N, Kara N, Pirhan D, et al. Evaluation of subfoveal choroidal thickness in children with type 1 diabetes mellitus: an EDI-OCT study. Semin Ophthalmol. 2014;29:27-31.
3. Elhabashy S, Elbarbary N, Nageb K, Mohammed M. Can optical coherence tomography predict early retinal microvascular pathology in type 1 diabetic adolescents without minimal diabetic retinopathy? A single-centre study. J Pediatr Endocrinol Metab. 2015;28:139-146.