Optic nerve ultrasonic evaluation in children and adolescents with type 1 diabetes mellitus

Changes in the optic nerve lead to decreased vision with a risk of complete loss in up to 20% of cases. Chronic hyperglycemia in diabetes mellitus is a key cause for the development of diabetic retinopathy and optic neuropathy. Insufficient attention is paid to the diagnosis of the optic nerve in children and adolescents, which leads to the development of pronounced structural changes and loss of time for reversible changes. Ultrasound is a safe, accessible method for assessing the optic nerve. The purpose of this research was to evaluate the ultrasound characteristics of the optic nerve in patients with type 1 diabetes mellitus compared with healthy individuals in childhood and adolescence depending on the anthropometric, laboratory data and the duration of the disease. Methods used: there was a single-center, prospective cohort study performed that involved 223 children aged 7 to 18 y/o (113 boys/110 girls), of which 173 had type 1 diabetes mellitus (92 boys/81 girls) and 50 represented the control group (21 boys/29 girls). All of the children had undergone the ophthalmological examination with the assessment of the fundus. Ultrasonic examination of the eyeball and orbit included the assessment of the anterior and posterior sections of the eyeball, optic nerve using B-mode and Doppler modes. Results: an increase in the thickness of the optic nerves with involvement of the membranes (р<0,05) in the groups “7 to 12 y/o” and “13 to 17 y/o” and without involvement of the membranes (р<0,05) in the group “13 to 17 y/o” were revealed in children and adolescents with type 1 diabetes mellitus in comparison with healthy children. Correlation analysis did not determine any significant connection between ultrasonic characteristics of the optic nerves and age, weight, height, lipid profile and glycated hemoglobin level (p<0.05). Conclusion: ultrasonic method allows characterization of the optic nerve, assessment of its structure and the condition of the membranes in children and adolescents with type 1 diabetes mellitus.