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Published on: January 12, 2024
Microaneurysm Turnover in Mild Non-Proliferative Diabetic Retinopathy is Associated with Progression and Development
Ana Rita Santos1,2,3,4, Luis Mendes1, Maria Helena Madeira1,3,4
1AIBILI-Association for Innovation and Biomedical Research on Light and Image, 3000-548 Coimbra, Portugal.
Background:
Analysis of retinal microaneurysm turnover (MAT) has been previously shown to contribute to the identification of eyes at risk of developing clinically significant complications associated with diabetic retinopathy (DR). We propose to further characterize MAT as a predictive biomarker of DR progression and development of vision-threatening complications.
Methods:
212 individuals with type 2 diabetes (T2D; ETDRS grades 20 and 35) were evaluated annually in a 5-year prospective, longitudinal study, by color fundus photography and optical coherence tomography. Endpoints were diabetic macular edema (DME) or proliferative retinopathy (PDR). MAT analysis included determination of MA formation and disappearance rates, automatically assessed using the RetMarkerDR®. Retinopathy severity progression was evaluated using step increases in ETDRS severity levels.
Results:
Of the 212 individuals, 172 completed the 5-year follow-up study or developed an endpoint (n = 27). MAT calculated at 1 year showed a significant difference between groups of endpoint developments (p = 0.018), particularly MA disappearance rate (p = 0.007). MAT also showed a significant difference between eyes with different ETDRS severity progression in the 5-year period (p = 0.035).
Conclusions:
MAT is an indicator of the development of DME and/or PDR as well as of DR severity progression in T2D individuals with mild retinopathy.
Insights
Microaneurysm turnover (MAT) predicts diabetic retinopathy (DR) progression and vision-threatening complications like diabetic macular edema (DME) and proliferative retinopathy (PDR) in type 2 diabetes (T2D) patients.
Area of Science:
- Ophthalmology
- Diabetology
- Medical Imaging Analysis
Background:
- Retinal microaneurysm turnover (MAT) aids in identifying eyes at risk for diabetic retinopathy (DR) complications.
- Characterizing MAT further can enhance its role as a predictive biomarker for DR progression and vision-threatening outcomes.
Purpose of the Study:
- To characterize microaneurysm turnover (MAT) as a predictive biomarker for diabetic retinopathy (DR) progression.
- To assess MAT's ability to predict the development of vision-threatening complications in individuals with type 2 diabetes (T2D).
Main Methods:
- A 5-year prospective longitudinal study involving 212 individuals with type 2 diabetes (T2D), ETDRS grades 20 and 35.
- Annual evaluations using color fundus photography and optical coherence tomography.
- Microaneurysm turnover (MAT) analysis (MA formation/disappearance rates) via RetMarkerDR®, with endpoints of diabetic macular edema (DME) or proliferative retinopathy (PDR).
Main Results:
- MAT analysis at 1 year showed significant differences between groups developing endpoints (p=0.018), notably the MA disappearance rate (p=0.007).
- MAT also demonstrated significant differences correlating with ETDRS severity progression over the 5-year study period (p=0.035).
Conclusions:
- Microaneurysm turnover (MAT) serves as an indicator for the development of diabetic macular edema (DME) and/or proliferative retinopathy (PDR).
- MAT also predicts the progression of diabetic retinopathy (DR) severity in individuals with type 2 diabetes (T2D) and mild retinopathy.
