Ocular manifestations of Type 1 diabetes mellitus in pediatric population.

ABSTRACT

Context To evaluate the necessity of ocular screening in Type 1 diabetes mellitus (DM). Aims: This study aims to investigate the diabetes‑related ocular changes according to the glycosylated hemoglobin (HbA1c) level and duration of diabetes in children and compare the results with nondiabetic healthy children. Settings and Design: Observational cross‑sectional study designed by ophthalmology and pediatric endocrinology clinics. Subjects and Methods: Forty‑two children with Type 1 DM, 42 healthy gender‑ and age‑matched children as controls were enrolled. All patients underwent ophthalmic and physical examination, with a review of medical history and current medication. HbA1c level, best corrected visual acuity, intraocular pressure (IOP), central corneal thickness (CCT), tear break‑up time (BUT), Schirmer test, dilated fundus examination findings, central retinal thickness (CRT), and total macular volume (TMV) measurements were noted. Statistical Analysis: Descriptive statistics, Student’s t‑test, Mann–Whitney U‑test, Chi‑square test for comparison of the group parameters and correlation analyses (Spearman analysis) were performed with SPSS statistical software 17.0 (SPSS Inc., Chicago, IL, USA). Results: Type 1 DM group exhibited significantly reduced Schirmer test, increased IOP and decreased retinal thickness relative to the age‑matched control group (P < 0.05) but no statistically significant difference was found for the BUT (P = 0.182) and for the CCT (P = 0.495). The correlations between the age, duration, HbA1c and IOP, BUT, Schirmer test, TMV, CRT measurements did not reach statistical significance. Conclusions: More frequent screening may be needed for complications, including neuropathy‑related dry eye syndrome, IOP changes, and diabetic retinopathy in children with Type 1 DM.