Evaluation of Eye Health in Children with Type 1 Diabetes Mellitus and Celiac Disease

Abstract

Background: Pediatric celiac disease (CeD) and type 1 diabetes mellitus (T1DM) have well established effects on eye health but comorbid effect is not  known.

Aim: To evaluate the eye health of children with T1DM and CeD to predict microvascular retinal pathologies by diagnosis of probable intraocular  pressure increase which is an important glaucoma trigger.

Patients and Methods: In this case-controlled study, 28 eyes of 14 children both T1DM and  CeD, with a mean age of 12.6 ± 3.9 years, and 28 eyes of gender-matched 14 healthy children as a control group were included. In both groups, detailed  ocular examinations and measurement of intraocular pressure (IOP), ocular pulse amplitude (OPA), thicknesses of ganglion cell layer (GCL), inner  plexiform layer (IPL), retinal nerve fiber layer (RNFL), and choroid thicknesses (CT) were done. All the patients with T1DM and CeD were newly diagnosed.  The evaluations of IOP and OPA were made using a Pascal dynamic tonometer and thicknesses measured by optical coherence tomography.

Results: The IOP and OPA values of the patient group were found to be statistically significantly higher than those of the control group (17.1 and 1.86 vs 14.78 and 1.57 mmHg, P <.0001, P <.001, respectively). IOP values of all patients were higher than IOP cut off levels for diagnosis of hypertension. CT was  significantly thinner in the patient group than in the control group (385.4 µm vs 331.71 µm, respectively, P < 0.03). No significant difference was found  between the groups in respect of GCL, IPL, and RNFL values.

Conclusion: The higher IOP and OPA values of the children with T1DM and CeD were  considered to be the result of the microvascular pathologies in T1DM and increased inflammation associated with CeD. High IOP and OPA values can lead  to damage in the eye as intraocular blood flow and choroidal perfusion are affected. In order to prevent these eye problems, measurement of IOP  and OPA should be done in children with diagnosis of T1DM and CeD and also follow up studies needed.