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Different Risk Profiles for Progression of Nonproliferative Diabetic Retinopathy: A 2-Year Study.

Inês P Marques1,2,3,4, Maria L Ribeiro1,2,3, Torcato P Santos1

  • 1AIBILI-Association for Innovation and Biomedical Research on Light and Image, Azinhaga Sta. Comba, Celas, 3000-548, Coimbra, Portugal.

Ophthalmology and Therapy
|December 10, 2022
PubMed
Summary

Diabetic retinopathy progression in type 2 diabetes (T2D) varies by risk phenotype. Phenotype C showed worsening associated with superficial capillary plexus changes, while Phenotype B involved deep capillary plexus changes and retinal thinning.

Keywords:
Capillary closureDiabetesNeurodegenerationRetinopathy

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Area of Science:

  • Ophthalmology
  • Diabetology
  • Medical Imaging

Background:

  • Nonproliferative diabetic retinopathy (NPDR) is a common complication of type 2 diabetes (T2D).
  • Understanding NPDR progression is crucial for managing T2D-related eye disease.
  • Risk stratification aids in predicting disease trajectory.

Purpose of the Study:

  • To characterize the 2-year progression of different NPDR risk phenotypes in T2D patients.
  • To correlate specific OCT and OCTA metrics with disease advancement.
  • To identify predictors of worsening NPDR.

Main Methods:

  • A 2-year prospective longitudinal cohort study (CORDIS) included 122 eyes from T2D individuals.
  • Ophthalmological examinations included visual acuity, color fundus photography, OCT, and OCTA.
  • Analysis focused on retinal thickness (GCL+IPL) and vascular metrics (VD, PD, AIS) in superficial and deep capillary plexuses for specific phenotypes (B and C).

Main Results:

  • Phenotype B progression linked to GCL+IPL thinning and deep capillary plexus (DCP) vessel closure.
  • Phenotype C showed GCL+IPL thinning and superficial capillary plexus (SCP) vessel closure, stabilizing in later stages.
  • Worsening ETDRS severity at 2 years correlated with phenotype C and SCP changes (VD, PD, AIS).

Conclusions:

  • ETDRS classification combined with risk phenotypes provides a novel approach to predict NPDR progression in T2D.
  • Distinct vascular and retinal layer changes characterize different NPDR risk phenotypes.
  • This stratification can inform targeted monitoring and treatment strategies.