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Diabetic Retinopathy01:27

Diabetic Retinopathy

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DefinitionDiabetic retinopathy is a microvascular complication of diabetes affecting the retinal blood vessels.Risk FactorsDiabetic retinopathy is present in almost all individuals with type 1 diabetes and more than 60% of those with type 2 diabetes after two decades of disease.The risk increases with poor glycemic control, hypertension, dyslipidemia, smoking, pregnancy, and puberty.Although cataracts and glaucoma are also more frequent in people with diabetes, retinopathy remains the leading...
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Patterns of Progression of Nonproliferative Diabetic Retinopathy Using Non-Invasive Imaging.

Inês Pereira Marques1,2,3,4, Maria Luísa Ribeiro1,3,4, Torcato Santos1

  • 1AIBILI - Association for Innovation and Biomedical Research on Light and Image (AIBILI), Coimbra, Portugal.

Translational Vision Science & Technology
|May 23, 2024
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Summary

Combining optical coherence tomography angiography (OCTA) and color fundus photography (CFP) effectively identifies nonproliferative diabetic retinopathy (NPDR) progression. Microaneurysm turnover analysis from CFP is crucial for distinguishing advanced NPDR stages, complementing OCTA metrics.

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Area of Science:

  • Ophthalmology
  • Medical Imaging
  • Diabetic Retinopathy Research

Background:

  • Diabetic retinopathy (DR) is a leading cause of vision loss in patients with type 2 diabetes.
  • Nonproliferative diabetic retinopathy (NPDR) is an early stage characterized by microaneurysms and capillary changes.
  • Accurate monitoring of NPDR progression is essential for timely intervention and preventing vision-threatening complications.

Purpose of the Study:

  • To investigate the combined utility of optical coherence tomography angiography (OCTA) metrics and color fundus photography (CFP) for identifying NPDR progression.
  • To assess the contribution of specific OCTA parameters (skeletonized vessel density and perfusion density) and microaneurysm turnover in characterizing NPDR severity and progression.

Main Methods:

  • A post hoc analysis of the prospective CORDIS cohort study (NCT03696810) involving 122 eyes over 2 years.
  • Ophthalmological examinations included OCTA of superficial and deep capillary plexi (SCP and DCP) and 7-field CFP.
  • Analysis involved OCTA metrics (SVD, PD), microaneurysm turnover, and Early Treatment Diabetic Retinopathy Study (ETDRS) grading.

Main Results:

  • Significant capillary nonperfusion was observed in the SCP for ETDRS level 20, and in both SCP and DCP for higher ETDRS levels (35, 43, 47).
  • Progression of capillary nonperfusion over 2 years was primarily noted in the DCP, particularly in the outer ring area for SVD and PD.
  • Microaneurysm turnover analysis successfully differentiated between ETDRS level 35 and more advanced stages (43, 47), a distinction not achievable with OCTA metrics alone.

Conclusions:

  • Combining OCTA imaging of retinal capillary plexi with microaneurysm turnover analysis from CFP provides a comprehensive approach to identifying NPDR progression patterns.
  • This integrated method enhances the characterization of NPDR, particularly in distinguishing between different severity levels of the disease.