Enlargement of the foveal avascular zone detected by optical coherence tomography angiography in diabetic children without diabetic retinopathy

PurposeEvaluation of foveal avascular zone (FAZ) in children with diabetes (DM) using OCTA.MethodsWe examined 112 diabetic children without DR aged 6-18years and 30 age-matched controls using Topcon OCT Angiography and measured FAZ in superficial (SCP) and deep capillary plexus (DCP). The study group was divided into three subgroups depending on DM duration group 1: <5years (n=40), group 2: 5-10years (n=42), group 3: >10years (n=30).ResultsThe mean DCP FAZ increased with DM duration from 502.2m(2) (SD 137.8) in group 1 to 523.9m(2) (SD 159.2) in group 2 and 539.7m(2) (SD 189.1) in group 3. Control group differed significantly from group 1 (p=0.0120), group 2 (p=0.0019) and group 3 (p=0.0011). The mean DCP to SCP FAZ surface ratio was 1.88 (SD 0.68) in the study vs 1.58 (SD 0.48) in the control group (p=0.0232). The DCP and SCP FAZ surface difference was 217.6m(2) (SD 100.8m(2)) in diabetics vs. 124.2m(2) (SD 72.8m(2)) in controls (p<0.0001). In the control group, it was significantly smaller than in group 1 (p<0.006), group 2 (p<0.0001) and group 3 (p<0.0001).ConclusionsChanges can be detected in FAZ of diabetic children before DR development which can be vital for screening.