Characterization and Automatic Discrimination between Predominant Hypoperfusion and Hyperperfusion Stages of NPDR

Area of Science:

• Ophthalmology
• Diabetology
• Medical Imaging

Background:

• Diabetic retinopathy (DR) is a leading cause of blindness.
• Vision-threatening complications include macular edema and proliferative retinopathy.
• Early identification of DR progression risk is crucial for timely intervention.

Purpose of the Study:

• To characterize the progression of nonproliferative diabetic retinopathy (NPDR).
• To develop interpretable models for identifying DR progression stages.
• To enable targeted therapies for halting diabetic retinal disease progression.

Main Methods:

• Utilized 82 imaging and systemic features (static and dynamic) to characterize NPDR.
• Trained interpretable models to distinguish between ETDRS levels 35 and 43-47.
• Data from 109 type 2 diabetes patients acquired over 2 years.

Main Results:

• NPDR progression observed from hypoperfusion to hyperperfusion.
• Static features model AUC: 0.84 ± 0.07.
• Static and dynamic features model AUC: 0.91 ± 0.05, indicating superior performance.

Conclusions:

• NPDR progression follows a distinct hypoperfusion to hyperperfusion pattern.
• Automated identification of NPDR progression stages is feasible and valuable.
• This approach can improve risk evaluation and guide targeted therapies to prevent vision loss.