Optic Neuritis in a Child With Poorly Controlled Type 1 Diabetes Mellitus: A Case Report

Alassaf, Anood; Mohamed, Khalid; Otaiby, Abdullah Al; Wraidat, Mohammad Al; Nashwan, Abdulqadir J.

doi:10.7759/cureus.33474

Cited by 3 publications

(3 citation statements)

References 11 publications

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“…Of note, most cases were post-infectious [ 9 , 12 ] or related to MOG antibody disease [ 11 , 14 ]. All patients presented with decreased visual acuity [ 9 - 14 ]; however, not all patients presented with optic pain [ 9 , 10 , 14 ] and dyschromatopsia. In all six cases, each patient was treated with intravenous methylprednisone with a resolution of symptoms.…”

Section: Discussionmentioning

confidence: 99%

Optic Neuritis in a 15-Year-Old Female Patient: A Case Report and Literature Review

Chan,

Pereira

2024

Cureus

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Optic neuritis represents a rare clinical entity leading to vision loss within the pediatric population. While not an urgent or life-threatening condition, optic neuritis may serve as a manifestation of various systemic diseases. When pediatric patients present with complaints of vision loss, it is imperative to consider optic neuritis as a potential differential diagnosis. This prompts further investigation to exclude systemic diseases capable of causing substantial morbidity. This article details a case report involving optic neuritis in a 15-year-old Hispanic female, outlining the investigation and management approach. Additionally, a review of the literature identifies six recent case reports documenting pediatric optic neuritis within the last year.

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Section: Discussionmentioning

confidence: 99%

Optic Neuritis in a 15-Year-Old Female Patient: A Case Report and Literature Review

Chan,

Pereira

2024

Cureus

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“…Type 1 diabetes mellitus (T1DM) represents one of the most common chronic diseases during childhood, with a significantly increasing incidence [4] of approximately 3 new cases per 100,000 people under 18 years old yearly [5]. This metabolic condition occurs through the autoimmune destruction of the pancreatic beta cells and a subsequent severe impairment of insulin production [6].…”

Section: Introductionmentioning

confidence: 99%

Correlations between Retinal Microvascular Parameters and Clinical Parameters in Young Patients with Type 1 Diabetes Mellitus: An Optical Coherence Tomography Angiography Study

Dan,

Mocanu,

Bălășoiu

et al. 2024

Diagnostics

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Objectives: In the current study, we investigated the correlations between retinal microvascular parameters using optical coherence tomography angiography (OCTA) and clinical parameters for a group of 69 young patients with type 1 diabetes mellitus (T1DM). Materials and Methods: This retrospective, exploratory study enrolled 69 patients between 5 years old and 30 years old who met the inclusion criteria. All the study participants underwent a comprehensive ophthalmic examination and OCTA scans for the evaluation of the retinal microcirculation. The retinal OCTA parameters were correlated with the following clinical parameters: the patient’s age at the onset of the disease, the duration of T1DM, the BMI at the time of enrollment in the study, the HbA1C values at onset, the mean values of HbA1C over the period of monitoring the disease and the degree of DKA at onset. Results: For the study group, the foveal avascular zone (FAZ) area and perimeter correlated positively with the mean value of HbA1C (Pearson correlation, Sig.2-Tailed Area: 0.044; perimeter: 0.049). The total vessel density in the superficial capillary plexus (SCP) correlated negatively with the duration of T1DM, based on the superior and inferior analyzed areas (Spearman correlation, Sig.2-Tailed SCP in total region: 0.002; SCP in the superior region: 0.024; SCP in the inferior region: 0.050). The foveal thickness also correlated negatively with the levels of diabetic ketoacidosis (DKA) at onset (Spearman correlation, Sig.2-Tailed: 0.034) and the levels of HbA1C at onset (Spearman correlation, Sig.2-Tailed: 0.047). Further on, the study patients were distributed into two groups according to the duration of the disease: group 1 included 32 patients with a duration of T1DM of less than 5 years, and group 2 included 37 patients with a duration of T1DM of more than 5 years. Independent t-tests were used to compare the OCTA retinal parameters for the two subgroups. While the FAZ-related parameters did not show significant statistical differences between the two groups, the vessel densities in both the SCP and DCP were significantly lower in group 2. Conclusions: Our data suggest that specific alterations in OCTA imaging biomarkers correlate with various clinical parameters: the FAZ area and perimeter increase with higher mean values of HbA1C, leading to poor metabolic control. Moreover, the SCP total vessel density decreases as the duration of T1DM increases. Regarding the vessel densities in the SCP and the DCP, they decrease with a duration of the disease of more than 5 years.

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“…Type 1 diabetes mellitus (type 1 DM) represents one of the most prevalent endocrinological diseases among children and young adults, with a growing incidence rate reaching up to 2.9 new cases per year per 100,000 persons below 15 years of age [ 1 ]. Although there is a continuous effort to improve insulin delivery systems and glucose monitoring systems, less than a third of type 1 DM patients achieve optimal glycemic control [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Retinal Microvascular Alterations in a Patient with Type 1 Diabetes Mellitus, Hemoglobin D Hemoglobinopathy, and High Myopia—Case Report and Review of the Literature

Dan,

Bălășoiu,

Puiu

et al. 2023

Diagnostics

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Type 1 diabetes mellitus (type 1 DM) is one of the most prevalent endocrinological diseases among children and young adults, with a growing incidence rate reaching up to 2.9 new cases per year per 100,000 persons below 15 years of age. We report a rare case of a 20-year-old female patient with type 1 DM, hemoglobin D (HbD) heterozygote variant and high myopia of −10.00 spheric diopters, and describe the retinal microvascular alterations visible on OCT angiography (angio-OCT). The patient also presented with a severe stature deficit (less than three standard deviations) and delayed puberty, which could not be explained only by suboptimal glycemic control and indicated possible hypopituitarism. HbA1c level evaluated with the high-performance liquid chromatography (HPLC) method was 6.5%, a falsely low value due to HbD hemoglobinopathy. On ophthalmic evaluation, the angio-OCT scan showed the following retinal microvascular alterations in the right eye (RE): the FAZ (Foveal Avascular Zone) area was 0.39 mm2, the FAZ perimeter was 2.88 mm, and the circularity index was 0.58. The following alterations were shown in the left eye (LE): the FAZ area was 0.34 mm2, the FAZ perimeter was 3.21 mm, and the circularity index was 0.41. Clinicians should consider high-performance retinal screening methods such as angio-OCT evaluation for young type 1 DM patients, especially for those with associated pathologies like high myopia and hemoglobinopathies. Moreover, multiple evaluation methods of HbA1c values are mandatory as hemoglobinopathies can interfere with the accuracy of HbA1c assay methods.

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Optic Neuritis in a Child With Poorly Controlled Type 1 Diabetes Mellitus: A Case Report

Cited by 3 publications

References 11 publications

Optic Neuritis in a 15-Year-Old Female Patient: A Case Report and Literature Review

Optic Neuritis in a 15-Year-Old Female Patient: A Case Report and Literature Review

Correlations between Retinal Microvascular Parameters and Clinical Parameters in Young Patients with Type 1 Diabetes Mellitus: An Optical Coherence Tomography Angiography Study

Retinal Microvascular Alterations in a Patient with Type 1 Diabetes Mellitus, Hemoglobin D Hemoglobinopathy, and High Myopia—Case Report and Review of the Literature

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