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Retinal oxygen saturation changes progressively over time in diabetic retinopathy.

Sveinn Hakon Hardarson1, Einar Stefánsson1,2, Toke Bek3

  • 1Institute of Physiology, Department of Medicine, University of Iceland, Reykjavik, Iceland.

Plos One
|May 12, 2021
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Summary

Diabetic patients show increased retinal oxygen saturation and decreased arteriovenous difference over time, even without changes in retinopathy grade. These metabolic changes may precede or be more sensitive indicators of disease progression than structural markers.

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Area of Science:

  • Ophthalmology
  • Diabetic Retinopathy Research
  • Vascular Physiology

Background:

  • Cross-sectional studies indicate elevated retinal vessel oxygen saturation in diabetic patients.
  • Diabetic retinopathy is a leading cause of vision loss, necessitating early detection and monitoring.
  • Understanding metabolic and structural changes in diabetic retinopathy is crucial for patient management.

Purpose of the Study:

  • To evaluate longitudinal changes in retinal oxygenation, vessel diameters, and retinopathy grade in diabetic patients.
  • To investigate the relationship between metabolic markers (oxygenation) and structural markers (vessel diameter, retinopathy) over time.
  • To determine if changes in retinal oxygen saturation precede or are more sensitive to disease progression than retinopathy grade.

Main Methods:

  • A prospective cohort study involving 214 diabetic patients.
  • Retinal oximetry was used to measure oxygen saturation and vessel diameters over a median follow-up of 3.0 years.
  • Fundus photography was used for semiquantitative grading of retinopathy and counting red lesions.

Main Results:

  • Retinopathy grade remained unchanged, but arteriolar and venular oxygen saturation increased annually.
  • The arteriovenous difference in oxygen saturation decreased over time.
  • Retinal arteriolar and venular diameters decreased, and red lesion counts increased, but these did not correlate with follow-up duration.

Conclusions:

  • Diabetic patients can experience increased retinal oxygen saturation and decreased arteriovenous difference over time without apparent changes in retinopathy grade.
  • These findings suggest that alterations in retinal oxygen saturation may be an early indicator of diabetic retinopathy progression.
  • Retinal oxygen saturation appears to be a more sensitive marker for disease progression than the current retinopathy grading system.