Citation: El-Fayoumi D, Badr Eldine NM, Esmael AF, Ghalwash D, Soliman HM. Retinal nerve fiber layer and ganglion cell complex thicknesses are reduced in children with type 1 diabetes with no evidence of vascular retinopathy. Invest Ophthalmol Vis Sci. 2016;57:5355-5360. DOI: 10.1167/iovs.16-19988 PURPOSE. To determine whether type 1 diabetes (T1DM) in children with a mean age of 12.21 6 3.04 years affects the retinal nerve fiber layer (RNFL) and ganglion cell complex (GCC) when compared to age-and sex-matched healthy children.METHODS. Forty-six children with T1DM with no diabetic retinopathy (DR) and 50 normal ageand sex-matched controls underwent full clinical ophthalmic and spectral-domain optical coherence tomography (SD-OCT) examination. Using RTVue Fourier-Domain OCT (version 6.11.0.12) average, superior, and inferior RNFL and GCC thicknesses (in lm) were measured. Mean values of patients and the control group were compared. RESULTS.In children with T1DM with no DR, the mean average RNFL thickness was 110.9 lm 6 10.46, and the mean GCC thickness was 95.59 lm 6 5.13; both were significantly thinner than the control group (115.62 lm and 99.30 lm, respectively). The retinal nerve fiber layer and GCC thickness showed no correlation to either age of onset, duration of the disease, or glycosylated hemoglobin (HbA1c). A positive correlation was found between the daily insulin dose and the average RNFL thickness (r ¼ 0.378, P ¼ 0.01). The average GCC in children with dyslipidemia was thinner than those with normal lipid profile (91.29 6 6.46 lm, 97.11 6 3.59 lm, respectively) with a P value of 0.011. CONCLUSIONS.Thinning of the RNFL and GCC in children with T1DM with no DR compared to healthy controls suggests that neurodegenerative changes occur in the absence of vascular changes. It also shows that neurodegeneration is not related to either disease duration, onset, or control.

Serious sight-threatening complications were not detected in our study; dry eye was the most common ocular finding, and the detected retinopathy was related to systemic hypertension and could not be correlated to either disease activity or duration.

All patients with ocular lupus should be carefully evaluated for systemic involvement and, vice versa, all patients diagnosed with SLE should have a thorough ocular examination and FFA, even if they had normal fundus.

Purpose: To evaluate retinal sensitivity in children who are on hydroxychloroquine (HCQ) for systemic lupus erythematosus using microperimetry and compare the results with those of the Humphrey visual field (HVF) 10-2 and spectral-domain optical coherence tomography (SD-OCT). Procedure: A case-control cross-sectional study including 19 patients (less than 18 years old) on HCQ for at least 5 years. Controls were 21 normal children. Participants underwent a complete ophthalmic examination, then were investigated using HVF 10-2, SD-OCT, and microperimetry. Results: Ocular examination revealed no abnormalities. The overall mean microperimetry sensitivity of the patients (15.75 dB) was not significantly different from that of the controls (16.35 dB). The HVF 10-2 showed a significant difference in the mean deviation of the patients. Conclusions and Message: Microperimetry was not more revealing than HVF 10-2 and SD-OCT. Larger studies are required to compare the diagnostic accuracy of screening modalities of retinal toxicity in children on HCQ.

High anisometropic myopia progresses rapidly in the first few years of life before becoming stable. [J Pediatr Ophthalmol Strabismus. 2017;54(5):282-286.].