Background. Optical coherence tomography angiography (OCT-A) is a promising tool for the detection of microvascular impairment at the preclinical stage of diabetic retinopathy (DR). Evaluation of dynamic OCT-A changes and their association with systemic factors can help to reveal early biomarkers of DR progression. Aim: to evaluate time-related OCT-A changes and their association with systemic factors in type 1 diabetes mellitus (DM1) patients with no apparent DR Materials and methods. 38 DM1 patients with no apparent DR and 39 healthy volunteers were included in the study. All participants underwent 7-field fundus photography, OCT and OCT-A. We analyzed OCT-A parameters (foveal avascular zone (FAZ) area (mm2), acircularity index (AI), vessel density (VD), skeletonized density (SD)) as well as the results of blood and urea tests. Results. After one year of observation, AI was significantly higher (p = 0.005) and VD0-300 was significantly lower in superficial vascular plexus (SVP, p < 0.0001) and deep capillary plexus (DCP, p = 0.032) in DM1 patients. We have also registered a positive correlation between AI and triglycerides (TG) level (r = 0.627, p = 0.007) as well as a negative correlation between ketones and VD (SVP VD0-300: r = -0.695, p = 0.030; intermediate capillary plexus (ICP, VD0-300: r = -0.551, p = 0.041; DCP, VD0-300: r = -0.704, p = 0.003; SVP, VD300-600: r = -0.853, p = 0.001). Conclusions. After one year of observation, we have registered an increase in AI level and a decline in VD in SVP and DCP which can be the earliest signs of DR progression. A significant correlation between these parameters and systemic factors indicates their role as potential DR biomarkers. © 2021 Scientific Centre for Family Health and Human Reproduction Problems. All rights reserved.