Korean J Ophthalmol > Epub ahead of print
DOI: https://doi.org/10.3341/kjo.2020.0106    [Epub ahead of print]
Published online June 21, 2021.
Evaluation of Macular and Retinal Nerve Fiber Layer Thickness in Children with Type 1 Diabetes Mellitus Without Retinopathy
Ismail Mohd-Ilham1,3, Evelyn Li Min Tai1,3, Hussain Suhaimi2,3, Ismail Shatriah1,3 
1Department of Ophthalmology and Visual Science, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
2Department of Pediatrics, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
3Hospital Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
Correspondence:  Ismail Shatriah,
Email: shatriah@usm.my
Received: 30 November 2020   • Revised: 30 May 2021   • Accepted: 3 June 2021
Abstract
Purpose
There are limited data from Asian countries regarding retinal thickness in children with type 1 diabetes mellitus (T1DM). This study aimed to compare the macular and retinal nerve fiber layer (RNFL) parameters between diabetic children without retinopathy and non-diabetic healthy children. We also evaluated the factors associated with RNFL thickness in children with T1DM.
Methods
A comparative cross-sectional study was conducted among children with T1DM and healthy children aged 7-17 years old in Hospital Universiti Sains Malaysia from 2017 to 2019. Children with retinal disease or glaucoma were excluded. Macular and RNFL thicknesses were measured using spectral-domain optical coherence tomography. Demographic information, duration of diabetes, blood pressure, body mass index, visual acuity, and retinal examination findings were documented. Glycosylated hemoglobin levels, renal function, and blood lipid levels were also collected. Statistical Package for the Social Sciences version 24 (IBM Corp., Armonk, NY, USA) was used for statistical analyses.
Results
Forty-one children with T1DM and 80 age- and gender-matched children were enrolled. Both genders were affected. Mean duration of DM was 3.66 years. The mean HbA1c levels in the T1DM group was 9.99%. The mean macular and RNFL thicknesses in children with T1DM were 277.56 (15.82) µm and 98.85 (12.05) µm, respectively. Children with T1DM had a significantly thinner average macula, superior outer macula, nasal outer macula, mean RNFL, and inferior RNFL thickness compared to controls (p<0.05). There was a significant association between nephropathy and the mean RNFL thickness.
Conclusion
Children with T1DM had significantly decreased mean macular and RNFL thicknesses. Nephropathy is associated with an increased RNFL thickness.
Key Words: Children, Type 1 Diabetes Mellitus, Macular thickness, Retinal nerve fiber layer thickness


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