Research Article Analysis of Retinal Perfusion in Children, Adolescents, and Young Adults with Type 1 Diabetes Using Optical Coherence Tomography Angiography Chiara Mameli , 1 Alessandro Invernizzi, 2,3 Alice Bolchini, 1 Giorgio Bedogni , 4 Elisa Giani, 1 Maddalena Macedoni, 1 Gianvincenzo Zuccotti, 1 Chiara Preziosa, 2 and Marco Pellegrini 2 1 Department of Pediatrics, Vittore Buzzi Children’s Hospital, Department of Biomedical and Clinical Science, University of Milan, Milan, Italy 2 Eye Clinic, Department of Biomedical and Clinical Science, Luigi Sacco Hospital, University of Milan, Milan, Italy 3 Save Sight Institute, University of Sydney, Sydney, Australia 4 Clinical Epidemiology Unit, Liver Research Center, Basovizza, Trieste, Italy Correspondence should be addressed to Chiara Mameli; chiara.mameli@unimi.it Received 5 November 2018; Revised 2 April 2019; Accepted 23 April 2019; Published 8 May 2019 Guest Editor: Stela Vujosevic Copyright © 2019 Chiara Mameli et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. We performed a cross-sectional study to analyze the retinal vasculature in children, adolescent, and young adults with type 1 diabetes using optical coherence tomography angiography (OCTA). Patients underwent funduscopic examination for diabetic retinopathy (DR) screening during an annual visit for the screening of diabetes-related complications which included the evaluation of glycated hemoglobin (HbA1c), microalbuminuria, lipid profile, arterial pressure, and neurological assessment. In addition, OCTA of the retinal vasculature was performed. Quantitative analysis of the OCTA images evaluated the vessel density at the superficial (SCP) and deep (DCP) capillary plexus of the retina. Structural vascular alterations were evaluated qualitatively. Results were compared to those obtained in a group of healthy age-, sex-, and pubertal stage-matched controls. The effect of age, disease duration, age at the disease onset, mean HbA1c since the onset, and lipid profile on vascular density was tested. Fifty-three patients (median age 15.5, IQR 12.4-19.4 years; 57% females) with type 1 diabetes and 48 controls were enrolled. The median (IQR) HbA1c was 7.6% (60 mmol/mol) (6.9-8.1%, 52-65 mmol/mol), and the median (IQR) duration of disease was 6.0 (3.3-10.3) years. Mean vessel density measured with OCTA was lower in patients compared to controls with the temporal sector showing the highest difference both in the SCP (0.55 vs. 0.57, p <0 001) and the DCP (0.63 vs. 0.65, p <0 001). None of the predictors was associated with the superficial and deep vascular densities. Only 2 patients had clinically detectable DR. Microvascular structural changes were found on OCTA in both of these patients and in one without funduscopic alterations. In conclusion, patients with type 1 diabetes without clinically detectable DR had decreased capillary density compared to controls on OCTA images. These findings may provide useful information for the screening and the management of patients with type 1 diabetes. Further studies are needed to confirm our results and their clinical relevance. 1. Introduction Type 1 diabetes is the most common metabolic disorder of childhood and adolescence. Its onset in pediatric age together with suboptimal metabolic control puts patients at a greater risk of developing diabetes-related complications [1]. Diabetic retinopathy (DR) is one of the most feared complica- tions of diabetes, leading to visual impairment and blindness if untreated. DR is uncommon before puberty, especially in children aged less than 15 years [2]. The reported prevalence of DR in children and young adults ranges from 10% to 58% depending on the studied population [3–7]. Hindawi Journal of Diabetes Research Volume 2019, Article ID 5410672, 8 pages https://doi.org/10.1155/2019/5410672