{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T04:10:36Z","timestamp":1773288636019,"version":"3.50.1"},"reference-count":66,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,1,8]],"date-time":"2023-01-08T00:00:00Z","timestamp":1673136000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Metabolism Res"],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Current diagnostic and treatment modalities target late stages of diabetic retinopathy (DR) when retinopathy has already been established. Novel and more sensitive strategies are needed. Optical coherence tomography angiography (OCTA) permits non\u2010invasive visualisation of retinal microcirculation. Fibroblast growth factor\u201021 (FGF21) plays an important role in glucose and lipid homoeostasis. This study assesses early OCTA changes among children and adolescents with type 1 diabetes (T1DM) compared to fundus photography and correlates them to diabetes\u2010duration, glycaemic control, and FGF21; hence, it determines their value in early detection of DR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methodology<\/jats:title>\n                    <jats:p>Hundred children and adolescents with T1DM were assessed for diabetes\u2010duration, insulin therapy, hypoglycemia, and diabetic\u2010ketoacidosis frequency, Tanner staging, glycated\u2010haemoglobin (HbA1c), fasting lipids, urinary albumin\/creatinine ratio, and serum FGF21. OCTA and fundus photography were done for the studied patients and 100 age, gender, and Tanner matched healthy controls.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The mean age of the children and adolescents with T1DM was 10.84\u00a0years, their mean diabetes\u2010duration was 3.27\u00a0years and their median FGF21 was 150\u00a0pg\/ml. FGF21 was significantly higher among children and adolescents with T1DM than controls (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001). Children and adolescents with T1DM had a significantly larger foveal avascular zone (FAZ) and lower peripapillary and inside\u2010disc capillary densities (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.05); with no significant fundus photography difference (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.155) than controls. FAZ was positively correlated and peripapillary and inside\u2010disc capillary densities were negatively correlated with diabetes\u2010duration, HbA1c, FGF21, and Tanner stage. FGF21 was significantly higher in T1DM children and adolescents having OCTA changes compared to those with normal OCTA (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.002). Multivariate\u2010regression revealed that FAZ is independently associated with diabetes\u2010duration, HbA1c and FGF21.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>OCTA changes start early in children and adolescents with T1DM long before the fundus changes. These changes are correlated with diabetes\u2010duration, puberty, glycaemic, and FGF21.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/dmrr.3598","type":"journal-article","created":{"date-parts":[[2022,12,9]],"date-time":"2022-12-09T23:35:15Z","timestamp":1670628915000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Changes in early optical coherence tomography angiography among children and adolescents with type 1 diabetes: Relation to fibroblast growth factor 21"],"prefix":"10.1002","volume":"39","author":[{"given":"Eman M.","family":"Sherif","sequence":"first","affiliation":[{"name":"Pediatrics and Adolescents Diabetes Unit Pediatrics Department Faculty of Medicine Ain\u2010Shams University  Cairo Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Randa M.","family":"Matter","sequence":"additional","affiliation":[{"name":"Pediatrics and Adolescents Diabetes Unit Pediatrics 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