COMPARING STAGES OF DIABETIC RETINOPATHY WITH SYSTEMIC VASCULAR STATUS USING FINGER PHOTOPLETHYSMOGRAPHY.

Area of Science:

• Ophthalmology and Vascular Health
• Biomedical Engineering
• Diabetes Research

Background:

• Diabetic retinopathy (DR) is a microvascular complication of diabetes mellitus.
• Systemic vascular health assessment is crucial for managing diabetes and its complications.
• Photoplethysmography (PPG) offers a non-invasive method to evaluate vascular function.

Purpose of the Study:

• To investigate the association between diabetic retinopathy (DR) severity and systemic vascular fitness using finger photoplethysmography (PPG).
• To evaluate PPG-derived vascular markers, including PPG fitness index, vascular risk prediction index, and vascular age, in patients with Type II diabetes mellitus and varying stages of DR.

Main Methods:

• A cross-sectional observational study included 141 patients with Type II diabetes mellitus.
• Data collected: blood pressure, visual acuity, glycated hemoglobin, central macular thickness, and PPG signals.
• PPG signals were analyzed to derive PPG fitness index, vascular risk prediction index, and vascular age, categorized by DR severity (Early Treatment Diabetic Retinopathy Study classification).

Main Results:

• Significant differences in blood pressure, glycated hemoglobin, visual acuity, and central macular thickness were observed across DR severity groups.
• Photoplethysmography fitness index, vascular risk prediction index, and vascular age showed significant variations across DR stages.
• Poorer PPG vascular markers (lower fitness index, higher vascular age, and higher risk index) were associated with more severe stages of DR, even after adjusting for age, blood pressure, and glycated hemoglobin.

Conclusions:

• More severe stages of diabetic retinopathy are associated with diminished systemic vascular fitness.
• Photoplethysmography is a valuable tool for assessing vascular health in diabetic patients and may reflect the systemic impact of DR.