ESPE Abstracts

Background: Few studies have investigated the association between the development and progression of diabetic retinopathy and autoimmune processes resulting from HLA genotype and the relationship of these genes with islet autoantibody status.

Objective: This study explored how serum diabetes autoantibodies are related to the development of early diabetic retinopathy (EDR) in children with type 1 diabetes mellitus (T1DM).

Methodology: In this prospective and observational study, 62 patients with T1DM who had not yet developed clinical DR were followed up for at least 5 years. Healthy volunteers aged 10–20 years were also included. Insulin, pancreatic islet cells and glutamic acid decarboxylase (GAD) autoantibodies were measured with an RIA kit at the time of T1DM diagnosis. Optical coherence tomography angiography (OCTA) was used to evaluate the foveal avascular zone (FAZ) and parafoveal vascular density (PVD) for the development of EDR among the groups. Patients’ OCTA findings were compared with those of healthy volunteers. The obtained data were analyzed using IBM SPSS Statistics for Windows, version 27.0. Spearman’s rank correlation test and regression analysis were performed to determine independent predictors of OCTA and T1DM parameters.

Results: Eighteen boys and forty-four girls with T1DM and a median age of 15.6 (10.08–20.88) years were evaluated. Healthy control participants with a median age of 15.3 (14.2–18.2) years were also included. The mean FAZ was greater in the T1DM group than in the healthy control group (P = 0.013, P = 0.119). The mean PVD was significantly lower in the T1DM group than in the healthy control group. There was no significant correlation between serum diabetes autoantibodies (GAD and insulin autoantibodies) and FAZ or PVD (FAZ and GAD; r = 0.138 P = 0.286, FAZ and anti-insulin; r = 0.100 P = 0.441, PVD and GAD; r = −0.151 P = 0.24, PVD and anti-insulin; r = −0.087 P = 0.499).

Conclusion: In patients with T1DM who did not develop clinical DR, OCTA revealed an increase in the FAZ and a decrease in the PVD, which was not associated with serum diabetes autoantibodies at the time of T1DM diagnosis. These results suggest that serum diabetes autoantibodies may not contribute to the development of EDR. Thus, studies with larger patient series are needed.