SDOCT-OCDUS assessment in Type-1 Diabetes after Islet Transplantation

Early increase of arterial blood flow velocities at Orbital Color-Doppler Ultrasound (OCDUS) in brittle Type-1 Diabetes after Pancreatic Islet Transplantation (PIT) was recently demonstrated. However few knowledge is available about the role of PIT in the retinal microcirculation and the evolution of Diabetic Retinopathy (DR), that is the major cause of visual loss in type-1 diabetic patients. We retrospectively studied 8 patients affected by Type-1 Diabetes with OCDUS and Spectral-Domain Optical Coherence Tomography (SDOCT), in order to investigate retinal blood flow and morphological retinal abnormalities (micropseudocysts -MPCs- and hyperreflective foci -HRFs-) before and 4 years after PIT, evaluating the relationship with glycometabolic changes (C-peptide). A timely PIT seems to determine a beneficial effect on the arterial retinal microcirculation, improving Peak Systolic Velocity of Central Retinal Artery (PSV-CRA) values. Besides, MPCs and HRFs could be early signs and interesting morphologic biomarkers - predictive of islet engraftment failure and glycometabolic impairment with C-peptide drop - in brittle type-1 diabetic patients.