Title of project

The Importance of Glycemic Control for the Development of Early Retinal Abnormalities in Children and Adolescents with Diabetes

Abstract

This project aims to identify and characterize the earliest capillary and neuronal changes in the retina of children and adolescents with type 1 diabetes using advanced imaging and functional testing. The goal is to improve clinical understanding of how both average blood glucose levels and glycemic stability influence the risk of developing diabetic retinopathy.

Phase 1 demonstrated that optical coherence tomography angiography (OCT-A) detects reduced capillary density in the superficial retinal plexus of children with diabetes, even in the absence of visible fundus pathology. These findings highlight a critical window for earlier detection and intervention. Phase 2 will expand the cohort to approximately 320 participants and integrate repeated OCT-A imaging with functional assessments and comprehensive glycemic profiling. Both HbA1c and glucose variability derived from continuous glucose monitoring (CGM) will be analyzed to determine their respective contributions to early retinal dysfunction.

By coupling high-resolution retinal imaging with precise metabolic data, the project aims to establish objective, clinically applicable markers of metabolic control and retinopathy risk, enabling earlier and more individualized monitoring of children and adolescents with diabetes. Ultimately, it aims to prevent vision loss, support overall health, and improve long-term outcomes, giving young patients the best chance for a healthy future with preserved vision and optimal systemic well-being.