Background: Diabetic retinopathy (DR) is the leading cause of blindness in type 1 Diabetes Mellitus (DM) patients,\nas a consequence of impaired blood flow in the retina. Optical coherence tomography angiography (OCTA) is a\nnewly developed, non-invasive, retinal imaging technique that permits adequate delineation of the perifoveal vascular\nnetwork. It allows the detection of paramacular areas of capillary non perfusion and/or enlargement of the foveal\navascular zone (FAZ), representing an excellent tool for assessment of DR. The relationship of these microvascular\nchanges with systemic factors such as metabolic control or duration of the disease still needs to be elucidated.\nMethods: Prospective, consecutive, large-scale OCTA study. A complete ocular examination including a comprehensive\nseries of OCTA images of different scan sizes captured with 2 OCT devices (Cirrus HD-OCT, Carl Zeiss Meditec, Dublin, CA,\nUSA, and Triton Deep Range Imaging OCT, Topcon Corp, Topcon, Japan) will be obtained as part of the yearly routine follow\nup visits in type 1 DM patients seen in the Diabetes Unit of the Endocrinology department which give written informed\nconsent to participate in the project. The aim of this study is to investigate the relationship between OCTAderived\nparameters and systemic factors, as metabolic control (Hb1Ac, lipid profile, cholesterol, etc), and other\nrelevant clinical factors as demographics or duration of the disease.\nDiscussion: This study is directed to investigate the relationship between the status of the perifoveal vascular\nnetwork and systemic markers of the disease, and in particular to study whether these changes reflect those\noccurring elsewhere in the body affected by diabetic microvascular disease, as the kidneys or the brain. If\nthese relationships were demonstrated, early detection of these microvascular changes by OCTA could lead to\nmodifications in the pharmacological management of type 1 diabetic patients, as a way to reduce the risk of\nfuture complications in both the eye and other organs.
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